Resistant schizophrenia in a patient with epilepsy

摘要

Psychotic syndromes associated with epilepsy are classified according to their chronological association with seizures into ictal, pos-ictal and interictal (brief or chronic) (Sachdev, 1998).Chronic interictal psychotic syndromes bear remarkable clinical similarity with primary schizophrenia and were therefore dubbed Schizophrenia-Like Psychoses of Epilepsy (SLPE). This similarity is at times so striking that some have questioned whether SLPE are not merely a coincidence (Toone, 2000). Moreover, two contradictory observations complicate our understanding of SLPE: seizures of growing intensity and frequency often precede psychotic symptoms (post-ictal psychosis) (Logsdail and Toone, 1988); alternatively, psychosis may emerge following seizure suppression and EEG normalization ("forced normalization"; Langosch and Trimble, 2002).