Predictive variables of interictal psychosis in epilepsy

Abstract

A family history of psychosis, earlier age at onset of epilepsy, complex partial seizures or generalized tonic clonic seizures, and borderline intellectual functioning were the most important predictors for development of interictal psychosis.

Enhancement of Central Dopaminergic Activity in the Kainate Model of Temporal Lobe Epilepsy: Implication for the Mechanism of Epileptic Psychosis

“…In particular, neurodevelopmental abnormalities in the mesial temporal lobe (eg hamartomatous lesions or gangliogliomas) have been indicated (Taylor, 1975;Roberts et al, 1990). More recent studies suggest that therapy with powerful antiepileptic drugs such as vigabatrin (Sander et al, 1991;Ferrie et al, 1996), and a family history of psychosis (Adachi et al, 2000) are also factors involved in the development of epileptic psychosis.…”

Schizophrenia-like psychoses of epilepsy

“…Adachi et al [28] reviewed the clinical data of 246 epilepsy patients with interictal psychosis and 658 control patients with epilepsy who had no history of psychotic episodes, and evaluated the variables for predicting the development of interictal psychosis in epilepsy. Patients with a positive family history of psychosis were found to be extremely susceptible to psychosis and the risk was nearly 40 times higher compared to patients without such family history.…”

“…On the other hand, Adachi et al [28] reported that age at onset of epilepsy was one of the most important predictors for the development of interictal psychosis, together with a family history of psychosis, type of seizures, and level of intelligence. In their study, patients with interictal psychosis had a significantly earlier age at onset of epilepsy.…”

“…Adachi et al [50] also stated that the location of epileptogenic focus did not appear to primarily affect the psychiatric features of patients with epilepsy, although they found that patients with frontal lobe epilepsy exhibited hebephrenic symptoms during the active phase of interictal psychosis, while patients with temporal lobe epilepsy tended to show paranoid symptoms. In their study on predictive variables of interictal psychosis of epilepsy, Adachi et al [28] employed multivariate analysis that revealed seizure type (such as complex partial seizures) to be statistically more strongly associated with psychosis than epilepsy type (such as temporal lobe epilepsy).…”

“…With respect to seizure type, Adachi et al [28] found a significantly higher frequency of complex partial seizures among patients with psychoses than those without psychoses. Schmitz and Wolf [51] also reported that ictal loss of consciousness, an indicator of widespread cerebral dysfunction, was a risk factor of psychosis in epilepsy, but not localized or lateralized cerebral lesion, in a large series of consecutive outpatient referrals with epilepsy.…”