Temporal epilepsy and psychosis - Comorbidities

Abstract

Introduction

The simultaneous presence of temporal epilepsy and psychosis includes a careful approach to diagnosis and titration of medication.

Aim

To achieve remission of comorbid diseases resistant to therapy.

Methods

Psychotherapy interview and support, laboratory measurements, EEG, cerebral CT and MRI scan, psychological testing.

Results

The patient was a girl 16 years of age. In 2011, she started experiencing auditory hallucinations of disturbing content, ideas of persecution, and she feared that people were going to kill her, all of which were bothering her deeply. In the family anamnesis, her grandmother and aunt both suffer from schizophrenia. In the first neurological assessment, there were no abberations. The patient was treated with high doses of various antipsychotics, but the hallucinations became unbearable to the extent that she was about to commit suicide. Anticonvulsive therapy was planned, and in the meantime, a second neurological assessment was performed, which confirmed the coexistence of temporal epilepsy. Combined therapy consisting of anticonvulsive and antipsychotic medication markedly abated the hallucinations. However, the patient began to feel cramping of the right arm, as well as experiencing the negative symptoms of psychosis. She wasn’t functioning normally anymore, she was distinctly adynamic, depressive, with a lack of initiative, and poor memory and concentration. Psychological testing confirmed significant cognitive, emotional and personality disorders (of organic source).

Conclusion

Treatment of the overlapping symptoms of temporal epilepsy and psychosis is complex, along with the presence of intellectual deterioration.

Disclosure of interest

The authors have not supplied their declaration of competing interest.