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Query: UMLS:C0014544 (epilepsy)
 64,704 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prevalences and types of psychiatric disorders connected with temporal lobe epilepsy and surgical treatment hereof are discussed. Studies comparing psychiatric morbidity among surgically treated patients and less selected groups of patients with epilepsy, respectively, are desired. Previous follow-up studies of patients undergoing temporal lobe resection point to a high prevalence of psychiatric disorders pre- and postoperatively, in terms of personality disturbances (especially aggression) and various psychotic disorders. On the basis of older studies, postoperative psychoses are believed to appear in 7-10% of surgically treated patients. New Brain Imaging and neurophysiological techniques permit a more precise focal diagnosis. Thus more selective surgical procedures have been introduced, e.g. resection of the amygdala and hippocampus. Together with an increased awareness of the importance of psycho-social factors and the absence of severe psychiatric disturbances for a good postoperative outcome this means that results of older studies may no longer apply. Studies reflecting present day conditions are needed.
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PMID:[Temporal lobe epilepsy--psychiatric aspects and surgical treatment]. 141 49

Twenty-five patients with epilepsy (mostly with partial seizures) who had responded favourably to a short-term trial of add-on vigabatrin entered maintenance treatment. After 52 to 78 months, 15 patients continue to take the drug with good therapeutic response. Median monthly seizure frequency during the last 2 months on vigabatrin in all patients, including drop-outs, was 3.5 (range 0-74) as compared with 10 (range 3-98) during an initial placebo period (p < 0.01). Drop-outs were caused by adverse events in 2 cases (ataxia and psychotic symptoms respectively), seizure breakthrough in 4 cases and reasons unrelated to treatment in 4 patients. In most patients, side effects were absent or mild, the most frequent complaint being weight gain. It is concluded that the antiepileptic efficacy and good clinical tolerability of vigabatrin are generally maintained during long-term treatment for up to 6 years.
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PMID:Six-year follow-up study on the efficacy and safety of vigabatrin in patients with epilepsy. 141 41

Two patients are reported, one with severe brain damage and epilepsy, and the other with limbic epilepsy, who were treated with unilateral microsurgical amygdalo-hippocampectomy for the control of rage and aggression. Both had significant improvement in their aggressiveness, and the second patient also improved in the frequency of his seizures and psychotic episodes. The significance of these observations for our understanding of the morphophysiological basis of rage and aggression is discussed.
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PMID:Amygdalo-hippocampectomy for pathological aggression. 147 33

Antiepileptic drugs (AEDs) are still the main treatment for epilepsy. The first drugs such as the bromides, phenobarbital (PB), and related barbituates were all found to be anticonvulsant by chance. They also all carried to some extent the disadvantages of slowing thinking and motor behavior. Bromides are now seldom used and (PB) is only used when other drugs fail, although it is an important drug in the third world because of its low cost. Carbamazepine (CBZ), valproate (VPA), and phenytoin (PHT) are the current first-line AEDs. All of these drugs vary in the extent of their effect on mood. These drugs have also all been used in the treatment of psychiatric disorders. CBZ has been used mainly as a mood normalizer and has had some success in treating hypermanic episodes. VPA has been used successfully in the treatment of cyclical psychoses, whereas PHT, although it had a vogue in the 1940s for the treatment of psychosis, is little used as a psychological treatment now.
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PMID:Antiepileptic drugs and their psychotropic effects. 148 34

A 34-year-old woman had three tonico-clonic seizures and aphasia revealing a left prerolandic infarct. Three weeks later, she began to develop psychiatric symptoms leading to the diagnosis of chronic hallucination psychosis. These symptoms were probably related to epilepsy and their cause was compatible with the diagnosis of interictal psychosis. It has been suggested that kindling of the mesolimbic system could account for psychosis in epilepsy. In our case, however, the sort time interval between the onset of epilepsy and the appearance of psychosis is not in favour of this mechanism.
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PMID:[Left prerolandic infarction with initial epilepsy. Development of chronic hallucination psychosis]. 149 30

First, the author makes reference to the psycho pathological and nosological questions associated with paranoid and schizophrenia-like psychoses in epilepsy and in particular to the non resolved problem of a distinction between these epileptic syndromes and the ones of schizophrenia. Starting from a phenomenological analysis of basic existential structures such as encounter or interpersonality, temporality and spatiality in a typical case of paranoid psychosis in epilepsy, the author tries to establish formal criteria which allow to distinguish these psychoses from schizophrenia. Thus it could be demonstrated that the structure of the encounter in the psychotic epileptic is quite conserved, both in what refers to the real and the delusional partner. His spatiality is characterized by the phenomenon of narrowness and his temporality by harassment, being necessary to underline the fact that, unlike what happens in schizophrenia, in the paranoid psychoses of epilepsy the space maintains its unity and the time its continuity. We could summarize the substantive difference between both types of paranoid psychoses with the following words: in paranoid syndromes in epilepsy what occurs is a change of state "within the world", while in schizophrenia it is a rather a modification of the "being-in-the world" itself or, with other words, it deals with a going out from the world constituted as community.
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PMID:[Differential phenomenology of the paranoid psychoses in epilepsy]. 149 10

We present here a case of Klinefelter's syndrome with epileptic psychosis. The patient was a 30-year-old male, who suffered from epilepsy for 23 years. He showed auditory hallucination, delusion of reference and delusion of grandeur. At present there are some cases of Klinefelter's syndrome with various psychiatric symptoms, but there are few cases of Klinefelter's syndrome with epileptic psychosis. These various neuropsychiatric symptoms of the present case are thought to be associated with a specific effect of chromosomal abnormality through the cerebral dysfunction.
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PMID:Klinefelter's syndrome and epileptic psychosis: a case report. 163 36

Based on a material of a clinico-epidemiological study of 451 cases of schizophrenia and 329 cases of epilepsy with psychotic manifestations, the clinico-prognostic correlations were established in the two aspects: nosological and from the standpoint of the progress of the pathological process. The concept of isomorphism and the concept of varying prediction of the psychotic manifestations in schizophrenia and epilepsy are interpreted from the viewpoint of the primary localization of brain derangement.
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PMID:[Comparative analysis of the clinico-epidemiological and prognostic data in schizophrenic and epileptic psychoses]. 166 4

We report the case of a boy whose development was normal until the age of three when regression with loss of speech occurred. Other anomalies included eating and sleep disorders, sterotyped behavior disorders, suggesting infantile psychosis. The electroencephalogram evidenced paroxysmal anomalies, particularly during sleep, with no clinical seizures. The diagnosis of epilepsia-acquired aphasia syndrome (Landau-Kleffner syndrome) was made. The psychotic disorders were not considered as a differential diagnosis but rather as intertwined with the elements of the syndrome. The relationship between acquired aphasia and psychosis are discussed.
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PMID:[Epilepsy-acquired aphasia syndrome with psychosis. Report of a case ]. 169 43

In five children with normal initial psychomotor development, a Landau-Kleffner syndrome appeared at age 3-7 years. No neuroanatomic lesions were noted. Aphasia and hyperkinesia were isolated in three patients and associated with global regression of higher cortical functions in one patient. Massive intellectual deterioration and psychotic behavior were associated with transient aphasia in one patient. The epilepsy (focal motor and generalized tonic-clonic seizures, subclinical EEG focal seizures during sleep, and atypical absences) always regressed spontaneously or with antiepileptic drug (AED) treatment. The EEG in waking patients showed focal and generalized spike-wave discharges on a normal background rhythm. Discharge topography and pattern changed frequently. During sleep, discharges always increased. At some time during syndrome development, all patients had bilateral spike-waves for greater than 85% of the sleep period, while at other times the discharges were discontinuous or continuous but focal or unilaterally hemispheric. Discharge topography and abundance changed from night to night. The abnormal EEG and the impaired higher functions developed and regressed together, but not with strict temporal correlation. Our own experience suggests that the Landau-Kleffner syndrome and epilepsy with continuous spike-wave activity in slow-wave sleep cannot be clearly differentiated. They may be different points on the spectrum of a single syndrome.
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PMID:Landau-Kleffner syndrome: a clinical and EEG study of five cases. 170 Sep 52


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