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Abstract

Psychosis commonly occurs as a direct result of complex partial seizure disorder (CPSD). This organic mental disorder is indeed "complex" and is easily and frequently misdiagnosed as a variety of functional disorders, including schizophrenia, schizoaffective disorder, bipolar illness, psychotic depression, and, at best, "atypical psychosis." However, this important clinical syndrome has several clinical features that suggest its presence and which often permit it to be distinguished from other forms of psychosis. Furthermore, this disorder can be successfully treated with limbic anticonvulsants, with or without neuroleptics and/or lithium, but it is generally refractory to neuroleptic medications alone. In this paper, the author reviews the available literature relevant to the clinical phenomenology and treatment of this topic and illustrates the clinical profiles of 10 treatment-refractory patients admitted to a state hospital with previously undiagnosed psychoses secondary to CPSD. This illness needs to be seriously considered in the differential diagnosis of severely ill patients with atypical psychoses refractory to traditional treatments.

A patient with medication-resistant epilepsy featuring psychosensorial and psychotic symptoms presenting with significant functional improvement on psychotherapeutic treatment: a case report

“…However, given the pro-convulsant properties of neuroleptic drugs in general, they should be prescribed with a great deal of parsimony when EEGs remain abnormal [ 22 ]. Reports of successful treatment of psychosis associated to complex partial seizures have shown good response to anti-convulsant medication such as carbamazepine and valproic acid [ 23 ], but this was not the case for our patient, which further underscores the possibility that the psychotherapeutic component of the treatment plan explains, at least to some extent, the progress noted for our patient. Finally, anti-epileptic drugs have been shown to decrease cognitive functioning [ 24 ], which was not the case with our patient; he remained stable and even improved on some fronts (for example, speed of information processing).…”