Characteristics of temporal lobe epilepsy with mesial temporal sclerosis, with special reference to psychotic episodes

Abstract

This study investigates the histories and the clinical course of 111 patients who had nonlesional temporal lobe epilepsy. We compared 61 patients with unilateral hippocampal sclerosis (UHS group) and 50 patients with minimal change (MRI negative group) assessed on the basis of MRI. In agreement with previous reports, we confirmed statistically that patients in the UHS group strongly tended to have had febrile convulsive status during early childhood or infancy and that habitual seizures tended to begin at a younger age than the other subset of nonlesional temporal lobe epilepsy. Strikingly, episodes of psychoses, especially postictal psychoses, occurred significantly more often in the UHS group than in the MRI negative group. Additional involvement of temporal neocortex further augmented this association. We stress the role of mesial temporal pathology, and its linkage to the temporal neocortex, in the genesis of postictal psychoses.

Psychoses in epilepsy: A comparison of postictal and interictal psychoses

“…Given its strong relation with mood disorders (in particular with mania), the item "grandiosity" was not included. Two supplementary features (reportedly being salient features of PP or IP [10,11]) were assessed: i) violent behavior (self-harm or violence directed against others) and ii) negative symptoms (at least one feature of the PANSS negative subscale such as blunted affect, emotional withdrawal, poor rapport, passive/apathetic social withdrawal, difficulty in abstract thinking, lack of spontaneity/flow of conversation, and stereotyped thinking). Evaluation of psychopathology was restricted to patients in whom sufficient information on mental status during psychosis was available.…”

Complete remission of epileptic psychosis after temporal lobectomy: case report

“…Its presentation is typically pleomorphic, with delusions and hallucinations, loose associations, mannerisms and mood swings 1,2 . Prevalence is of 4% in cases of apparently non-refractory epilepsy 3 and of 7-18% in cases of refractory epilepsy 2,4,5 . Interictal psychoses are chronic and/or recurrent, with delusions, hallucinations, thought disorders, disorganized behavior, relative absence of catatonic symptoms, mood swings, apragmatism and emotional blunting (less intense than that observed in classic schizophrenia), may progress with persistence of psychotic symptoms, psycho-organic sequelae, suicide attempts, multiple hospitalizations and functional descent 6,7 .…”

Síndrome de personalidade interictal na epilepsia do lobo temporal não-dominante: relato de caso

“…Neste contexto, deve-se importância especial à esclerose mesial temporal. Esta entidade neuropatológica, observada em nosso paciente, está frequentemente associada a convulsões febris prolongadas na infância 24 , com início precoce das crises (na primeira ou segunda década de vida) e epilepsia parcial de difícil controle.…”