KOCHEN Sara Silvia
congresos y reuniones científicas
Analysis of Risk Factors for Postictal and Interictal Psychosis in Patients with Refractory Epilepsy
D'ALESSIO, L, GIAGANTE, B, IBARRA, V, PAPAYANIS, C, ODDO, S, SOLÍS, P, SALGADO, P, SILVA, W, SEOANE, E, CONSALVO, D, KOCHEN, S.
Congreso; 26th International Epilepsy Congress; 2005
Purpose: Epilepsy patients are at a higher risk for acute and chronic psychotic states. In this study we analysed the presence of risk factors for developing postictal sychosis (PIP) and interictal psychosis (IP). Methods: 113 consecutive patients with refractory epilepsy were evaluated; 82% had temporal origin. All patients underwent complete neurological, neuroimaging, neuropsychological, and psychiatric assessment. Clinical, demographic, psychiatric, neuropsychological, and neuroimaging data were assessed by logistic regression. Results: 24% of patients had a positive history for PIP and 38% had IP psychosis. 51% did not show any type of psychosis. Epilepsy time duration, presence of febrile seizure history, and the absence of experiential aura were significantly more frequent in patients with PIP (p< 0.05). 8% of patients with temporal lobe epilepsy had bilateral hippocampal sclerosis in the MRI, and 62% of them had PIP and 75% IP (p< 0.05 compared with patients with no history of psychosis). The presence of hippocampal sclerosis plus in RMN was associated with the absence of PIP history (p< 0.05). Conclusion: Postictal psychosis was more common in patients with longer epilepsy duration, febrile seizure history, and absence of experiential auras. The presence of bilateral hippocampal sclerosis was associated with both PIP and IP. Other features associated with IP were not found. Risk factors for PIP seem to be more distinctiveness than those for IP.