[Analysis of psychotic disorders in patients with refractory partial epilepsy, psychiatric diagnoses and clinical aspects].
BACKGROUND
The association between psychotic disorders and epilepsy has been controversial. Different subtypes of psychotic disorders in epilepsy patients have been described according to temporal relationship with seizures-postictal (PIP), interictal (IIP) and bimodal (BP) psychoses are described in literature.


OBJECTIVE
Determine clinical characteristics of patients with refractory partial epilepsy and psychoses and compare the results with a control group of patients with refractory partial epilepsy without psychoses.


METHODS
A total of 57 patients with refractory partial epilepsy and psychotic disorders (psychotic group [PG]) and 56 patients with refractory partial epilepsy and without psychoses (control group, CG) were evaluated according to DSM-IV criteria and SCID-I. All patients underwent complete neurological, neuroimaging, neuropsychological, and psychiatric assessment. Clinical, demographic and neuroimaging data were compared between patients in CG and PG.


RESULTS
In PG 15 patients (26 %) had criteria for PIP, 29 patients (51%) for IIP and 13 patients (23%) for BP. Epilepsy time duration and bilateral hippocampal sclerosis were significantly more frequent in patients with psichosis. PG patients had a longer evolution time of epilepsy and greater frequency of bilateral hippocampal sclerosis (p < 0.05). No differences were found between psychoses subtypes.


CONCLUSIONS
Longer evolution of seizures and the presence of bilateral hippocampal sclerosis may increase propensity to develop psychoses in patients with refractory partial epilepsy.
D'Alessio
L
L
Centro de Derivación de Epilepsia, Servicio de Neurología, Hospital Ramos Mejía. ldalessio@intramed.net.ar
Giagante
B
B
Ibarra
V
V
Papayannis
C
C
Oddo
S
S
Solís
P
P
Consalvo
D
D
Silva
W
W
Donnoli
V
V
Zieher
L M
LM
Kochen
S
S
D000328:Adult; D001921:Brain / Q000503:physiopathology; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006624:Hippocampus / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology*; D012032:Refractory Period, Electrophysiological / Q000502:physiology*; D012598:Sclerosis / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology