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

Adachi, Naoto; Oana, Yasunori; Okubo, Yoshiro; Hara, Tsunekatsu; Onuma, Teiichi

doi:10.1006/ebeh.2000.0113

Cited by 17 publications

(36 citation statements)

References 20 publications

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“…According to these criteria, patients present with two or more of the following symptoms: 1) delusions, 2) hallucinations, 3) disorganized speech, 4) disorganized or catatonic behavior, and 5) negative symptoms, with at least one episode lasting for 1 month or more, in the absence of a schizoaffective disorder diagnosis or mood disorder with psychotic features. In addition, the psychosis developed after the onset of epilepsy, all psychotic episodes lasted more than 24 h and occurred interictally–during seizure-free periods or between habitual seizures–in a state of full consciousness [16], [34]–[36]. Ictal psychotic phenomenon, postictal psychosis (psychotic events occurring within seven days of a seizure or clusters of seizures), and brief interictal psychosis (all episodes resolve in less than 1 month) were excluded.…”

Section: Methodsmentioning

confidence: 99%

Resting-State EEG Source Localization and Functional Connectivity in Schizophrenia-Like Psychosis of Epilepsy

et al. 2011

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BackgroundIt is unclear whether, like in schizophrenia, psychosis-related disruption in connectivity between certain regions, as an index of intrinsic functional disintegration, occurs in schizophrenia-like psychosis of epilepsy (SLPE). In this study, we sought to determine abnormal patterns of resting-state EEG oscillations and functional connectivity in patients with SLPE, compared with nonpsychotic epilepsy patients, and to assess correlations with psychopathological deficits.Methodology/Principal FindingsResting EEG was recorded in 21 patients with focal epilepsy and SLPE and in 21 clinically-matched non-psychotic epilepsy controls. Source current density and functional connectivity were determined using eLORETA software. For connectivity analysis, a novel nonlinear connectivity measure called “lagged phase synchronization” was used. We found increased theta oscillations in regions involved in the default mode network (DMN), namely the medial and lateral parietal cortex bilaterally in the psychotic patients relative to their nonpsychotic counterparts. In addition, patients with psychosis had increased beta temporo-prefrontal connectivity in the hemisphere with predominant seizure focus. This functional connectivity in temporo-prefrontal circuits correlated with positive symptoms. Additionally, there was increased interhemispheric phase synchronization between the auditory cortex of the affected temporal lobe and the Broca's area correlating with auditory hallucination scores.Conclusions/SignificanceIn addition to dysfunction of parietal regions that are part of the DMN, resting-state disrupted connectivity of the medial temporal cortex with prefrontal areas that are either involved in the DMN or implicated in psychopathological dysfunction may be critical to schizophrenia-like psychosis, especially in individuals with temporal lobe epilepsy. This suggests that DMN deficits might be a core neurobiological feature of the disorder, and that abnormalities in theta oscillations and beta phase synchronization represent the underlying neural activity.

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Section: Methodsmentioning

confidence: 99%

Resting-State EEG Source Localization and Functional Connectivity in Schizophrenia-Like Psychosis of Epilepsy

et al. 2011

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“…In addition, in a 10-year follow-up study by Omnuma, 64% of epilepsy-with-psychosis patients had a chronic course that was "comparable or worse than that of schizophrenia" (74). This is in agreement with a study by Matsuura et al, who found that of 128 patients, a chronic course was seen in 34%, another 6% became chronic after recurrent episodes, and another 34% continued with episodic symptoms (75).…”

Section: Outcome and Treatment (Epilepsy Vs Schizophrenia)mentioning

confidence: 53%

“…Psychotic states associated with AED induction and alternative psychosis presented as nonshizophrenia disorders and were differentiated from the nuclear schizophrenic group. Finally, Matsuura et al evaluated 128 epilepsy and psychosis patients and compared them with an epilepsy control group (75). A new five-axis classification scheme was proposed based on ICD-10.…”

Section: Comparison With Schizophreniamentioning

confidence: 99%

Is the Psychopathology of Epilepsy Different from That of Nonepileptic Patients?

Kanner

Barry

2001

Epilepsy & Behavior

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“…Normalmente se resolvem com a volta das crises aos padrões habituais (Matsuura et al, 2000;Kanner e Kuzniecky, 2001).…”

Section: Classificação Dos Transtornos Mentais Associados à Epilepsiaunclassified

“…Sistemas classificatórios de natureza dimensional podem apresentar maior utilidade terapêutica do que os de natureza categorial (Matsuura et al, 2000;Van Os et al, 1999). Em função disto e das limitações apresentadas pelos atuais sistemas classificatórios dos transtornos mentais associados à epilepsia, sistemas classificatórios multidimensionais foram propostos, particularmente no caso das psicoses associadas à epilepsia.…”

Section: Diagnóstico Multidimensionalunclassified

Transtornos mentais associados à epilepsia

Marchetti

Castro

Kurcgant³

et al. 2005

Rev. psiquiatr. clín.

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ResumoEpilepsia é o mais freqüente transtorno neurológico sério, atingindo 50 milhões de pessoas no mundo, 40 milhões delas em países em desenvolvimento. Embora seja um problema predominantemente tratável, nestes países a maioria dos pacientes permanece sem tratamento. Provavelmente uma das principais causas para isto seja o estigma que atinge as pessoas com epilepsia. Tal fato se agrava ainda mais quando à epilepsia se associam transtornos mentais, que ocorrem com prevalência aumentada. Os pacientes com epilepsia e transtornos mentais sofrem o que se chama de "duplo estigma", que freqüentemente os deixa sem tratamento. É provável, particularmente em países em desenvolvimento, que psiquiatras se defrontem com pacientes com epilepsia nos diferentes locais de atendimento. Os autores revisam diferentes aspectos dos principais transtornos mentais associados à epilepsia.Palavras-chave: Epilepsia, transtornos mentais, transtornos psicóticos, transtornos depressivos, crises não-epilépticas psicogênicas. AbstractEpilepsy is the most common serious neurological disorder. Worldwide, around 50 million people have epilepsy, 40 million of which in developing countries. Though epilepsy is predominantly treatable, most patients in these countries remain without treatment. It is likely that one of the main reasons is the stigma associated with epilepsy. This problem increases when mental disorders are associated with epilepsy, a fairly frequent occurrence. Patients with epilepsy and mental disorders are exposed to a "double stigma", which frequently leads to complete absence of treatment. It is probable that, particularly in developing countries, psychiatrists will be involved with the treatment of people with epilepsy. The authors review different aspects of the most important mental disorders associated with epilepsy.

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

Cited by 17 publications

References 20 publications

Resting-State EEG Source Localization and Functional Connectivity in Schizophrenia-Like Psychosis of Epilepsy

Resting-State EEG Source Localization and Functional Connectivity in Schizophrenia-Like Psychosis of Epilepsy

Is the Psychopathology of Epilepsy Different from That of Nonepileptic Patients?

Transtornos mentais associados à epilepsia

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