Analysis of psychotic disorders in patients with refractory partial epilepsy

D`ALESSIO LUCIANA, GIAGANTE BRENDA, IBARRA VIVIANA, PAPAYANNIS CRISTINA, ODDO SILVIA, SOLÍS PATRICIA, CONSALVO DAMIÁN, SILVA WALTER, DONNOLI VICENTE, ZIEHER LUIS MARÍA, KOCHEN SILVIA.

ACTAS ESPAñOLAS DE PSIQUIATRíA

Ars medica

Lugar: Barcelona; Año: 2008 vol. 36 p. 138 - 143

1139-9287

Introduction. The association between psychotic disorders and epilepsy has been controversial. Different subtypes of psychotic disorders in epilepsy patients have been described according to temporal relationship with seizures-postictal (PIP), interictal (IIP) and bimodal (BP) psychoses are described in literature. Objectives. Determine clinical characteristics of patients with refractory partial epilepsy and psychoses and compare the results with a control group of patients with refractory partial epilepsy without psychoses. Methods. A total of 57 patients with refractory partial epilepsy and psychotic disorders (psychotic group [PG]) and 56 patients with refractory partial epilepsy and without psychoses (control group [CG]) were evaluated according to DSM IV criteria and SCID I. All patients underwent complete neurological, neuroimaging, neuropsychological, and psychiatric assessment. Clinical, demographic and neuroimaging data were compared between patients in CG and PG. Results. In PG, 15 patients (26%) had criteria for PIP, 29 patients (51%) for IIP and 13 patients (23%) for BP. Epilepsy time duration and bilateral hippocampal sclerosis were significantly more frequent in patients in PG (p<0.05). No differences were found between psychoses subtypes. Conclusions. Longer evolution of seizures and the presence of bilateral hippocampal sclerosis may increase propensity to develop psychoses in patients with refractory partial epilepsy. Longer evolution of seizures and the presence of bilateral hippocampal sclerosis may increase propensity to develop psychoses in patients with refractory partial epilepsy.