&lt;sup&gt;123&lt;/sup&gt;I-IMP SPECT Brain Imaging in Epileptic Psychosis: A Study of Two Cases of Temporal Lobe Epilepsy with Schizophrenia-Like Syndrome

Jibiki, Itsuki; Maeda, Tamami; Kubôta, Takashi; Yamaguchi, Nariyoshi

doi:10.1159/000119025

Cited by 24 publications

(9 citation statements)

References 13 publications

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“…A relationship between TLE and psychosis is still discussed; however, some authors supposed that the apparent excess of TLE in patients with both epilepsy and psychosis is explained by the fact that TLE is the most common type of chronic epilepsy [44, 45]. Several studies postulated that psychosis affects in particular patients with left TLE [46,47,48,49,50]. In our sample, only 7 patients presented psychotic features (3% of the total sample, and 8% of the EPI-PSY group), making any conclusion in terms of lateralization difficult.…”

Section: Discussionmentioning

confidence: 99%

Psychiatric Comorbidity in Patients Evaluated for Chronic Epilepsy: A Differential Role of the Right Hemisphere?

et al. 2009

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Introduction: Psychiatric disorders are known to occur frequently in chronic epilepsy. The aim of this study is to investigate the prevalence of psychiatric comorbidity and its relationship to regional cerebral dysfunction in patients admitted to a tertiary epilepsy center for epilepsy surgery. Methods: 217 patients were investigated. A presurgical workup was performed and allowed precise localization of the epileptogenic focus in 156 patients. Sixty-one patients had multifocal or generalized discharges. After 1–3 psychiatric interviews, a psychiatric diagnosis was made (DSM-IV classification). Results: Psychiatric comorbidity was found in 85 patients (39%), more often in those with right or bilateral hemispheric dysfunction (74%, p = 0.04) with no difference between temporal or extratemporal foci location frequency. Additionally, patients with psychiatric disorders were less likely to undergo epilepsy surgery compared to ‘epilepsy-only’ patients (p = 0.003), despite similar good outcome in patients with and without psychiatric comorbidity. Conclusions: Right-sided or bilateral foci seem to represent a risk factor for psychiatric comorbidity in epilepsy, although we did not find any particular association between a psychiatric syndrome and focus localization. Recognition and treatment of psychiatric comorbidity is of major importance since its presence may interfere with patient’s decision making for epilepsy surgery treatment.

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Section: Discussionmentioning

confidence: 99%

Psychiatric Comorbidity in Patients Evaluated for Chronic Epilepsy: A Differential Role of the Right Hemisphere?

et al. 2009

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“…Studies other than EEG provided some evidence that hyperfunction may be involved in the pathogenesis of psychosis. A single‐photon emission computed tomography (SPECT) study conducted by Jibiki et al (9) reported two cases of periictal psychosis showing hyperperfusion in the temporolimbic system during psychotic states. Another SPECT study of four patients with temporal lobe epilepsy demonstrated medial frontal hyperperfusion during psychosis (10).…”

Section: Discussionmentioning

confidence: 99%

Acute Psychosis During Intracranial EEG Monitoring: Close Relationship Between Psychotic Symptoms and Discharges in Amygdala

et al. 2001

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Summary:Purpose: This report examined the underlying mechanism of psychosis associated with epilepsy.Methods: An adult patient with epilepsy manifesting acute psychosis during long-term EEG monitoring is presented, together with a literature review on this subject.Results: A 25-year-old woman with intractable temporal lobe epilepsy developed acute psychosis while she underwent long-term intracranial EEG monitoring. After a clustering of seizures, she manifested psychotic symptoms including hallucination, stupor, and repeated fear. The transition of psychotic symptoms corresponded to the changes in frequency and morphology of seizure discharges restricted to the left amygdala. Improvement of psychosis coincided with disappearance of seizure discharges.Conclusions: This case confirmed a close relationship between psychotic symptoms and seizure discharges in the left amygdala. It is suggested that paroxysmal bombardment of the medial temporal lobe structure may be a pathogenetic factor of acute psychosis associated with epilepsy.

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“…A pilot SPECT study was carried out to compare rCBF in patients with epilepsy with and without a schizophrenia-like psychosis: SLPE patients exhibited a significant reduction in the normalized rCBF index in the left hemisphere that was confined to the mediotemporal region Jibiki et al (102), studying the rCBF patterns with SPECT, suggested that temporolimbic dysfunction, particularly hyperfunction in the temporolimbic system in the dominant left hemisphere, appears to arise at the time of the psychotic state in epileptic psychosis (102). consistent with the theory that a state of psychosis arises when episodic dopamine excess is superimposed on a trait of basic dopamine deficiency in the striatum.…”

Section: Neuroimaging In Epileptic Psychosesmentioning

confidence: 99%

Behavioral, Psychotic, and Anxiety Disorders in Epilepsy: Etiology, Clinical Features, and Therapeutic Implications

1999

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Summary: This chapter deals with some aspects of psychiatric disturbances in people with epilepsy. Because depression and its treatment are extensively described later in this issue, they are not discussed here. The same pertains to forced normalization. Key Words: Epilepsy-Anxiety-PsychosisDepress ion-Qua1 i ty of 1 i fe-Ps e u do s ei zure s-A n t idepressants-Antipsychotics-Antiepileptic drugs.Although most people with epilepsy lead a normal emotional and cognitive life, neurobehavioral problems can be found in a large number of patients. Higher rates of psychopathology are observed in people with epilepsy relative to the general population (1,2), to other neurologic control groups (3), and to people with chronic nonneurologic disorders (1,4). In particular, increased psychopathology is more common in temporal lobe epilepsy (TLE) than in generalized epilepsy (5). Nevertheless, many issues remain highly controversial, owing in part to several methodologic problems, such as the nosographic approach, the sample examined, the type of control groups, the comparison among nonhomogeneous forms of epilepsy, and the different antiepileptic drugs (AEDs).Psychiatric disturbances can be related either to involvement of brain structures (biologic pathogenesis) or to the chronic characteristics of epilepsy (psychosocial pathogenesis). These psychiatric symptoms may develop in relationship to the seizures (in prodromal, ictal, or postictal periods) but more commonly are present in a chronic interictal condition.The wide range of clinical diversity is related to the anatomic foci, to patterns of spread, and to biologic or psychological differences among patients. Interictal behavioral changes in epilepsy remain controversial and difficult to define, mainly because pathogenesis may be attributable to several factors, such as epilepsy itself, possible brain lesions, the AEDs prescribed, and psychosocial problems (6). On the other hand, the existence of cognitive changes in epilepsy is well established, and Addrress correspondence and reprint requests to Dr. Riccardo Tom at Dipartimento di Neuroscienze, via Cherasco 11, 10126 Torino, Italy.sometimes the presence of cognitive disorders can facilitate the appearance of psychiatric disturbances (7).One of the most widely discussed problems is the incidence of psychiatric pathology in epilepsy, with a wide range of values in the literature related to the type of study. Epilepsy is characterized by a broad spectrum of severity. Ideally, patients for study trials should be selected consecutively from a general epilepsy population, but most epidemiologic studies are carried out in centers for epilepsy and include many refractory subjects who demonstrate a range of pathologic disturbances more severe than those observed in the general population of patients with epilepsy. In community studies, the prevalence of associated psychiatric disorders is low, whereas in specialty referral centers, particularly those serving indigent populations, the prevalence can rise to 25-50%: Among patient...

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<sup>123</sup>I-IMP SPECT Brain Imaging in Epileptic Psychosis: A Study of Two Cases of Temporal Lobe Epilepsy with Schizophrenia-Like Syndrome

Cited by 24 publications

References 13 publications

Psychiatric Comorbidity in Patients Evaluated for Chronic Epilepsy: A Differential Role of the Right Hemisphere?

Psychiatric Comorbidity in Patients Evaluated for Chronic Epilepsy: A Differential Role of the Right Hemisphere?

Acute Psychosis During Intracranial EEG Monitoring: Close Relationship Between Psychotic Symptoms and Discharges in Amygdala

Behavioral, Psychotic, and Anxiety Disorders in Epilepsy: Etiology, Clinical Features, and Therapeutic Implications

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