Diagnostic challenge in neuropsychiatry: two case reports
- 44 Downloads
Temporal lobe epilepsy straddles the borderland between psychiatry and neurology. Since this condition may involve gross disorders of thought, emotion, and sensory disturbances in the absence of tonic clonic seizures, psychiatrists may often fail to recognize the epileptic origin of the disorder. Our objective was to portray two case reports to increase recognition of common psychiatric symptoms and syndromes manifested in epilepsy.
Descriptive analysis of two females, suffering from derealization — depersonalization syndrome, hallucinations, and delusions.
Both patients were being treated for decades for depression and schizophrenia; however no positive treatment results resulted. A cooperative team of psychiatrists and neurologists of the Kaunas Medical Academy revealed epileptic roots of these cases, which resulted in treatment changes from antipsychotics to mood stabilizers. This new treatment showed long-acting positive outpatient outcomes.
Contemporary medical science could show improved outcomes not only by fragmenting into smaller specialized pieces, but also associating into bigger units, especially in the case of psychiatry. However, more exhaustive research should be provided to confirm such necessity.
KeywordsEpilepsy Hallucinations Delusions Psychosis Antipsychotics
Unable to display preview. Download preview PDF.
- de Araújo Filho G.M., da Silva J.M., Mazetto L., Marchetti R.L., Yacubian E.M., Psychoses of epilepsy: a study comparing the clinical features of patients with focal versus generalized epilepsies, Epilepsy Behav., 2011, 20(4), 355–358Google Scholar
- Khalsa S., Moore S.A., Van Hoesen G.W., Hughlings Jackson and the role of the entorhinal cortex in temporal lobe epilepsy: From Patient A to Doctor Z, 2006, 9(3), 524–531Google Scholar
- Selimbeyoglu A., Parvizi J., Electrical stimulation of the human brain: perceptual and behavioral phenomena reported in the old and new literature, Front. Hum. Neurosci., 2010, 4(46), 1–11Google Scholar
- Restak R., Complex partial seizures present diagnostic challenge, Psych. Times, 1995, 12(9), 1–6Google Scholar
- Bragatti J.A., Torres C.M., Londero R.G., Assmann J.B., Fontana V, Martin K.C., et al., Prevalence of psychiatric comorbidities in temporal lobe epilepsy: the value of structured psychiatric interviews, Epi. Disord., 2010, 12(4), 283–291Google Scholar
- Devinsky O., Hafler D.A., Victor J., Embarrassment as the aura of a complex partial seizure, Neurol., 1982, 32(11), 1284–1285Google Scholar
- Haut S., Differentiating migraine from epilepsy, Adv. Stud. Med., 2005, 5(6A), 658–665Google Scholar
- Canuet L., Ishii R., Iwase M., Ikezawa K., Kurimoto R., Takahashi H., et al., Psychopathology and working memory-induced activation of the prefrontal cortex in schizophrenia-like psychosis of epilepsy: Evidence from magnetoencephalography, Psychiatry. Clin. Neurosci., 2001, 65(2), 183–190CrossRefGoogle Scholar