Epileptiform discharges in psychiatric patients: a controversy in need of resurrection.
The current view of the psychiatric significance of inter-ictal spike discharges (IIS) in nonepileptic, psychiatric patients is that the discharges are "incidental" and are of no clinical significance. Hence, despite a voluminous literature suggestive that such discharges may have clinical relevance, electroencephalograms are hardly ever recorded in nonepileptic psychiatric patients. This literature is briefly summarized, and one detailed example of a disorder (i.e., autistic spectrum disorders) where such discharges are particularly common is provided. The argument is made that this is an area of psychiatry that is under-investigated and that research devoted to elucidating the mechanisms of development of IIS, their possible clinical relevance, and the role of anticonvulsants in managing such patients, could be very profitable.
Wayne State University, Department of Psychiatry and Behavioral Neurosciences, 2751 E. Jefferson, Detroit, Ml 48207, USA. nboutros@med.wayne.edu
Nash
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Boutros
D000200:Action Potentials; D000818:Animals; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods*; D004827:Epilepsy / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D001523:Mental Disorders / Q000150:complications / Q000503:physiopathology*; D008959:Models, Neurological; D009415:Nerve Net / Q000503:physiopathology*