Back to Journals » Neuropsychiatric Disease and Treatment » Volume 6 » Issue 1

Recurrent schizophrenia-like psychosis as first manifestation of epilepsy: a diagnostic challenge in neuropsychiatry

Authors Verhoeven W, Egger J, Gunning W, Bevers, de Pont B

Published 3 May 2010 Volume 2010:6(1) Pages 227—231

DOI https://doi.org/10.2147/NDT.S11104

Review by Single-blind

Peer reviewer comments 3

Willem MA Verhoeven1,2, Jos IM Egger1,3, W Boudewijn Gunning4, Martijn Bevers1, Boudewijn JHB de Pont1

1Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Neuropsychiatry, Venray, The Netherlands; 2Erasmus University Medical Centre, Department of Psychiatry, Rotterdam, The Netherlands; 3Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands; 4Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands

Abstract: Since the 1950s, several studies have been carried out to investigate the occurrence of schizophrenia-like psychoses in epilepsy. The psychopathological profile comprises symptoms from the affective, schizophrenic, and cognitive domains and the prevalence varies between 2% to 20%. Classification of such conditions is performed according to their temporal relationship with the seizure itself. Although it is well known that epilepsy may be associated with psychotic disorders, it is less widely recognized that relapsing psychotic phenomena may be the first and only symptom of epilepsy. In this research, two patients are described who were initially referred for recurrent episodes of bipolar affective disorder and schizophrenic psychosis, respectively. In both patients, a diagnosis of relapsing postictal psychotic states due to previously undiagnosed epilepsy was made and consequently, treatment with antiepileptics was started. During follow up over several months, they remained free of both epileptic and psychotic symptoms. Given the kaleidoscopic nature of the postictal psychosis and full recovery from this, such psychoses best meet the criteria for a cycloid psychosis. These observations illustrate diagnostic and therapeutic pitfalls due to the conceptual disintegration emerging from the inadequate separation between psychiatry and neurology. Therefore, the importance of a neuropsychiatric viewpoint should be promoted.
Keywords: postictal psychosis, epilepsy, classification, cycloid psychosis, neuropsychiatry

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF] 

 

Other articles by this author:

Copy number variants in a sample of patients with psychotic disorders: is standard screening relevant for actual clinical practice?

Van de Kerkhof NW, Feenstra I, van der Heijden FM,  De Leeuw N, Pfundt R, Stöber G, Egger JI, Verhoeven WM

Neuropsychiatric Disease and Treatment 2012, 8:295-300

Published Date: 12 July 2012

Phelan-McDermid syndrome in two adult brothers: atypical bipolar disorder as its psychopathological phenotype?

Verhoeven WMA, Egger JIM, Willemsen MH, de Leijer GJM, Kleefstra T

Neuropsychiatric Disease and Treatment 2012, 8:175-179

Published Date: 19 April 2012

Recurrent major depression, ataxia, and cardiomyopathy: association with a novel POLG mutation?

Verhoeven WMA, Egger JIM, Kremer BPH, de Pont BJHB, Marcelis CLM

Neuropsychiatric Disease and Treatment 2011, 7:293-296

Published Date: 15 May 2011

Top-down or bottom-up: Contrasting perspectives on psychiatric diagnoses

Willem MA Verhoeven, Siegfried Tuinier, Ineke van der Burgt

Biologics: Targets and Therapy 2008, 2:409-417

Published Date: 12 September 2008

Readers of this article also read:

Green synthesis of water-soluble nontoxic polymeric nanocomposites containing silver nanoparticles

Prozorova GF, Pozdnyakov AS, Kuznetsova NP, Korzhova SA, Emel’yanov AI, Ermakova TG, Fadeeva TV, Sosedova LM

International Journal of Nanomedicine 2014, 9:1883-1889

Published Date: 16 April 2014

Methacrylic-based nanogels for the pH-sensitive delivery of 5-Fluorouracil in the colon

Ashwanikumar N, Kumar NA, Nair SA, Kumar GS

International Journal of Nanomedicine 2012, 7:5769-5779

Published Date: 15 November 2012

A novel preparation method for silicone oil nanoemulsions and its application for coating hair with silicone

Hu Z, Liao M, Chen Y, Cai Y, Meng L, Liu Y, Lv N, Liu Z, Yuan W

International Journal of Nanomedicine 2012, 7:5719-5724

Published Date: 12 November 2012

Cross-linked acrylic hydrogel for the controlled delivery of hydrophobic drugs in cancer therapy

Deepa G, Thulasidasan AK, Anto RJ, Pillai JJ, Kumar GS

International Journal of Nanomedicine 2012, 7:4077-4088

Published Date: 27 July 2012

Crystallization after intravitreal ganciclovir injection

Pitipol Choopong, Nattaporn Tesavibul, Nattawut Rodanant

Clinical Ophthalmology 2010, 4:709-711

Published Date: 14 July 2010