Development of Psychosis in Two Cases with Epilepsy Diagnosis: Clinical Findings, Magnetic Resonance Imaging Features, and Neuropsychological Assessment

Abstract

Epilepsy-related psychosis is generally separated into 3 subgroups: postictal, interictal, and bimodal psychosis. However, if the psychosis continues for 1 month or longer, it is defined as chronic schizophrenia-like psychosis. It tends to occur 10 to 15 years after the onset of epilepsy, and cannot easily be distinguished from schizophrenia. In controlled trials, the risk of developing a psychotic disorder was 10-times higher in epileptic patients than in patients with other neurological disorders. In this presentation, 2 patients with epilepsy and chronic schizophrenia-like psychosis were diagnosed according to clinical and radiological findings. In both cases, psychotic symptoms appeared after the onset of epileptic seizures. Delusions and hallucinations were present as positive symptomatology. The intensity and severity of epileptic seizures decreased after the onset of psychotic symptoms in both cases. Forced normalization is an important concept for continued discussion.

Keywords

• epilepsy
• epilepsy-related psychosis
• forced normalization