Bertrand de Toffol, Michael Trimble, Dale C Hesdorffer, Lauren Taylor, Perminder Sachdev, Maurice Clancy, Naoto Adachi, José Augusto Bragatti, Marco Mula, Kousuke Kanemoto
The recognition and treatment of psychosis in persons with epilepsy (PWE) is recommended with the apparent dilemma between treating psychosis and opening the possibility of exacerbating seizures. The pooled prevalence estimate of psychosis in PWE is 5.6%. It has been proposed that a 'two hit' model, requiring both aberrant limbic activity and impaired frontal control, may account for the wide range of clinical phenotypes. The role of antiepileptic drugs in psychosis in PWE remains unclear. Alternating psychosis, the clinical phenomenon of a reciprocal relationship between psychosis and seizures, is unlikely to be an exclusively antiepileptic drug-specific phenomenon but rather, linked to the neurobiological mechanisms underlying seizure control...
November 2018: Epilepsy & Behavior: E&B