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

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 intract...

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Bibliographic Details
Published in:Epilepsia (Copenhagen) 2001-06, Vol.42 (6), p.719-724
Main Authors: Takeda, Youji, Inoue, Yushi, Tottori, Takayasu, Mihara, Tadahiro
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Amygdala
Amygdala - physiopathology
Biological and medical sciences
Comorbidity
Electrodes, Implanted
Electroencephalography - methods
Electroencephalography - statistics & numerical data
Epilepsy, Temporal Lobe - diagnosis
Epilepsy, Temporal Lobe - epidemiology
Epilepsy, Temporal Lobe - physiopathology
Female
Functional Laterality - physiology
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Intracranial EEG
Medical sciences
Monitoring, Physiologic - methods
Monitoring, Physiologic - statistics & numerical data
Nervous system (semeiology, syndromes)
Neurology
Postictal psychosis
Psychotic Disorders - diagnosis
Psychotic Disorders - epidemiology
Psychotic Disorders - physiopathology
Temporal Lobe - physiopathology
Temporal lobe epilepsy
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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.
ISSN:0013-9580
1528-1167
DOI:10.1046/j.1528-1157.2001.08700.x