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Interictal Psychiatric Disorders

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Abstract

The presence and clinical relevance of chronic (interictal) behavioural problems in patients with epilepsy have been recognised since the times of Hippocrates. Behavioural symptoms are commonly reported by patients with epilepsy and have a multifactorial aetiology, encompassing neurobiological and psychosocial factors. The behavioural profiles of antiepileptic drugs often contribute to behavioural changes in patients with both treatment-refractory and controlled seizures. Temporal lobe seizures are the most common type of focal seizures and often involve limbic system structures, as in mesial temporal lobe epilepsy (which is characterised by temporolimbic seizures). There is some evidence that patients with temporal lobe epilepsy are at higher risk for anxiety, depression, and psychosis, compared to patients with other form of epilepsy. Specifically, it has been suggested that both behavioural and personality changes may occur as a consequence of chronic temporolimbic irritability. The behavioural spectrum of temporal lobe epilepsy provides further evidence that the temporal lobe and limbic system play an important role in the organisation of human behaviour. Schizophrenia-like psychosis of epilepsy and alternative psychosis (forced normalisation) are rare but highly impairing neuropsychiatric conditions. The association between temporal lobe epilepsy and specific personality traits (temporal lobe epilepsy personality disorder or ‘Gastaut-Geschwind syndrome’) is still controversial.

Melancholics ordinarily become epileptics, and epileptics, melancholics: what determines the preference is the direction the malady takes; if it bears upon the body, epilepsy, if upon the intelligence, melancholics

Hippocrates (around 400 BC)

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Cavanna, A.E. (2018). Interictal Psychiatric Disorders. In: Motion and Emotion. Springer, Cham. https://doi.org/10.1007/978-3-319-89330-3_13

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  • DOI: https://doi.org/10.1007/978-3-319-89330-3_13

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