Classification of the Clinical Course of Delusional and/or Hallucinatory States in Epilepsy

Proposal for a New Five-Axis Classification Scheme for Psychoses of Epilepsy

“…A lack of a lateralization difference and a relatively high rate of bilateral foci in psychotic patients, as in the present study, have been reported previously (20,23,26).…”

“…Eight cases showed recurrent episodes at an earlier stage and chronic course at a later stage. Previous descriptions of such patients can be found in the literature (2,11,12,23,26).…”

Epileptic psychoses and anticonvulsant drug treatment

“…Suppression of epileptic activity in the cortex with simultaneous preservation, or strengthening of seizure activity in deep brain regions may be the underlying mechanisms 78 McKenna et al 9 speculated that both episodic and chronic psychoses may be related to increased seizure activity in deep brain regions, and patients exhibiting both postictal and alternative psychoses10 support this hypothesis.…”

Psychoses in Epilepsy: A Review of Japanese Studies

“…Ogata et al (54) reported two cases whose interictal psychoses, with increased discharges in scalp EEGs, were diminished rapidly by diazepam administration, suggesting the psychosis was an epileptic phenomenon. Further, many case reports have indicated both postictal psychoses in some periods and alternative psychosis in another period (18,44,45,47,55), which suggests that both psychoses may have similar mechanisms.…”

“…Some reports stressed the predominance of a left-sided focus (92,94) or bilateral foci (47,93) as a risk factor for developing psychoses, while two large studies reported no side differences in patients with TLE and psychoses (28,42). However, the limitation of determining the laterality of the epileptic focus only by scalp EEG should be taken into consideration (96).…”