title: Homicide during postictal psychosis.
abstract: Postictal psychosis is characterized by a fluctuating combination of thought disorder, auditory and visual hallucinations, delusions, paranoia, affective change, and aggression including violent behavior. We present a case of homicide following a cluster of seizures. The patient's history and postictal behavior were his consistent with postictal psychosis. Contributing factors resulting in homicide may have included increased seizure frequency associated with a change in his AED regimen seizure frequency. The AED change to levetiracetam may also have increased impulsiveness with diminished mood regulation following discontinuation of carbamazepine. There is evidence that he had a cluster of seizures immediately prior to the murder which may have resulted in the postictal disinhibition of frontal lobe inhibitory systems. This homicide and other violent behaviors associated with postictal psychosis may be avoided with earlier recognition and treatment.
authors: Department of Neurology, University of Florida, 1149 Newell Drive, Rm L3-100, Gainesville, FL 32611, USA.
authors: Stephan
authors: S
authors: Eisenschenk
authors: Community Behavioral Services, 1212 N.W. 12th Ave., Ste. B, Gainesville, FL 32601, USA.
authors: Harry
authors: H
authors: Krop
authors: Department of Neurology, NYU School of Medicine, 223 East 34th Street, New York, NY 10016, USA.
authors: Orrin
authors: O
authors: Devinsky
keywords: Epilepsy; Homicide; Medical–legal; Postictal psychosis