Prevalence of bipolar symptoms in epilepsy vs other chronic health disorders

摘要

Utilizing the Mood Disorder Questionnaire (MDQ), Ettinger et al. observed a high incidence of bipolar symptoms in patients self- reported as epileptic. Half the subjects with bipolar symptoms by MDQ claimed a previous diagnosis of bipolar disorder. The authors suggest that antiepileptic drug (AED) therapy may be effective considering the relationship between altered brain physiology and mood.I submitted a related observation to the American Psychiatric Association's 159th annual meeting. Forty-two referred patients (24 women, mean age 37 years) with a history of bipolar I or II (Diagnostic and Statistical Manual of Mental Disorders-IV criteria) underwent a behavioral neurologic assessment including EEG. None of these patients received prior AED treatment. Eighteen (45%) had EEG abnormalities classified as a focal dysrhythmia grade III (Mayo Clinic classification) and 12 had dysrhythmia grade II (28%).In 21 of the 30 patients with EEG abnormalities (70%), AED therapy that included lamotrigine, levetiracetam, topiramate, or oxcarbazepine proved effective in stabilizing mood without serious adverse event in 18 (85%) over 6 to 60 months (mean 36). Because none of these patients had a prior history of epilepsy, a diagnosis of interictal dysthymic disorder was excluded.These observations confirm those of Ettinger et al.'s that physiologic assessment in behavioral disorders and behavioral assessment in epilepsy should be further investigated.