Evidence-Based Reviews

EEGs and epilepsy: When seizures mimic psychiatric illness

Author and Disclosure Information

 

References

Ictal depression-like symptoms can be seen with temporal lobe complex partial seizures. Many patients with these seizures have simple partial seizures (auras) that manifest as brief (usually less than 1 minute) intense feelings of fear or impending doom, or of “the life drained out” of them. These symptoms may arise from seizures involving mesial temporal regions. They do not usually require treatment besides AEDs.

The idea that patients with temporal lobe epilepsy may have a particular personality type is controversial. Retrospective data first suggested that certain traits (e.g., altered sexual behavior, anger, emotionality and obsessionalism, hypergraphia, and hyper-religiosity) could be found consistently in patients with temporal lobe epilepsy.6 This personality inventory was sometimes used to diagnose epilepsy. Subsequent studies have not validated the original data, although the cluster of personality traits can certainly occur in some patients.7-9

Related resources

  • Epilepsy Foundation. www.epilepsyfoundation.org
  • Engel J, Pedley TA (eds). Epilepsy: A comprehensive textbook. Philadelphia: Lippincott-Raven, 1998.

Drug brand names

  • Carbamazepine • Tegretol
  • Ethosuximide • Zarontin
  • Lorazepam • Ativan
  • Phenytoin • Dilantin
  • Valproate • Depakote

Disclosure

The author reports that he receives research/grant support from, is a consultant to, and is on the speakers’ bureau of GlaxoSmithKline, UCBPharma, and Ortho-McNeil Pharmaceuticals; receives research/grant support from and is a consultant to Schwarz Pharma; is a consultant to Pfizer Inc., Elan Pharmaceuticals, and Shire Pharmaceuticals; and is on the speakers’ bureau of Abbott Laboratories, Cyberonics, and Shire Pharmaceuticals.

Pages

Recommended Reading

Five red flags that rule out ADHD in children
MDedge Psychiatry
Questioning ADHD red flags
MDedge Psychiatry
Autism: A three-step practical approach to making the diagnosis
MDedge Psychiatry
Attention-deficit/hyperactivity disorder: Tips to individualize drug therapy
MDedge Psychiatry