Forced normalization at the interface between epilepsy and psychiatry

E. S. Krishnamoorthy, M. R. Trimble, J. W.A.S. Sander, Andres M. Kanner

Research output: Contribution to journalArticlepeer-review

93 Scopus citations


In 1953, Landolt described a group of patients with poorly controlled epilepsy who had psychotic episodes associated with remission of their seizures and disappearance of epileptiform activity on their EEGs. He called this phenomenon "forced normalization." Since then, neurologists and psychiatrists have been intrigued by this phenomenon, and although it has been also reported by others, its existence continues to be the source of much debate. In this article, we review the clinical characteristics and potential pathogenic mechanisms of forced normalization and illustrate the complexities inherent in reaching this diagnosis, as well as its differential diagnosis in two representative cases.

Original languageEnglish (US)
Pages (from-to)303-308
Number of pages6
JournalEpilepsy and Behavior
Issue number4
StatePublished - Aug 1 2002
Externally publishedYes


  • Alternative psychosis
  • Depression
  • Intractable epilepsy
  • Psychosis

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience


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