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A case of postictal psychosis

McGill University
Publication Date
  • Case Reports
  • Medicine
  • Physics


MJM 9.1 final quark.qxd 22 MJM 2008 11(1):22-24 Copyright © 2008 by MJM CASE REPORT *To whom correspondence should be addressed Lisette Musaib-Ali 476 Clinton Avenue, Apt 1A Brooklyn, NY, US, 11238 Email: [email protected] INTRODUCTION Patients with a long-standing history of seizures are more susceptible to develop major psychiatric disorders including chronic interictal psychosis and episodic psychotic states (1,2). The different psychotic syndromes associated with epilepsy are normally defined based on their chronological relation to the seizures. Interictal psychosis occurs without an antecedent seizure, or an increase in seizure activity (1), and results in persistent psychotic states of varying intervals (3). Postictal psychosis, on the other hand, is an episodic psychotic state that classically follows exacerbations of seizures, particularly clusters of complex partial seizures with or without generalization (4). A lucid period of 12 hours to 6 days after termination of seizure activity precedes the onset of psychiatric symptoms, which often remit spontaneously within days or weeks (5). Patients frequently present with auditory, olfactory, gustatory and/or visceral hallucinations, paranoid ideation, and cognitive dysfunction. CASE REPORT Ms. T. is a 31-year-old female who presented in a confused, but alert state after having experienced 3 episodes of seizure activity in 6 days. Upon interviewing she reported that she did not feel like her usual self and feared that something was wrong with her brain. Following her second seizure, she began having visceral hallucinations in her abdomen and groin. Within 24 hours of her third seizure, she had begun to hear voices emerging from her abdomen. The synchronicity of these two symptoms produced a deep anxiety that she was becoming homosexual. The patient also expressed a feeling of responsibility for the suffering of innocent people and as a result, believed that she was being watched. Upon declaration of suicidal intentions, she was

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