Risk Factors for Postictal Psychosis: It’s Not the Temporal Lobe

Abnormal interictal activity, indeterminate localization of seizures, encephalitis, or family histories of neuropsychiatric disorders increase psychosis risk.

Postictal psychosis (PIP) occurs within 1 week after a seizure or seizure cluster in approximately 6% of individuals in video EEG (VEEG) monitoring studies. The common clinical wisdom dictates that this phenomenon is more common in temporal lobe epilepsy. In a case-control study, researchers retrospectively examined the risk factors for PIP among 153 consecutive patients with partial epilepsy who were undergoing VEEG for presurgical evaluation; 59 of the patients had experienced PIP, and 94 (controls) did not.

All participants had a clinical psychiatric interview. Psychosis was defined according to the DSM-IV: hallucinations, delusions, or grossly disorganized behavior. Patients who had other psychiatric or medical conditions that could expl…

Reviewing Author

Jonathan Silver, MD

Disclosures

RoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions

Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience

Leadership Positions in Professional SocietiesNorth American Brain Injury Association (Board Member); National Institute on Disability, Independent Living, and Rehabilitation Research (Chair of Data Monitoring Safety Board for study of donepezil on cognition after traumatic brain injury)

Jonathan Silver, MD

Disclosures

RoyaltiesTextbook of Traumatic Brain Injury, 2nd and 3rd editions

Editorial BoardsUpToDate; Journal of Neuropsychiatry and Clinical Neuroscience