Peri-ictal symptoms as the prototypic psychiatric phenomena of epilepsy Psychiatric symptoms in epilepsy are classified according to their temporal relation with seizure occurrence. Thus, they are divided into two big classes: interictal and peri-ictal. Interictal symptoms are independent of seizure occurrence. The peri-ictal symptoms are time-locked to the seizure occurrence and hence they are subdivided into symptoms that precede (pre-ictal), follow (postictal), or those that are the expression of the actual seizure (ictal). Peri-ictal psychiatric symptoms have been recognized for a long time; they were described in the writings of Gowers (Gowers 1881) and Hughlings Jackson (1931) in the nineteenth century and by Kraepelin (1923) in the early twentieth century. Peri-ictal symptoms may occur as isolated symptoms (e.g. only auditory hallucinations or irritability) or as a cluster of symptoms that mimic depressive, anxiety, or psychotic episodes, which may (or may not) be associated with cognitive and neurological signs and symptoms. Despite their relatively high prevalence, they are rarely identified by clinicians and hence systematic investigations of peri-ictal psychiatric phenomena are scarce. Furthermore, failure to recognize the nature of these symptoms leads to frequent misdiagnosis (see below) as interictal psychiatric disorders. The purpose of this chapter is to review the most relevant clinical aspects of peri-ictal symptomatology. Pre-ictal psychiatric phenomena It is not unusual for patients to report that they can predict the impending occurrence of their seizure by several hours to up to two days.
|Original language||English (US)|
|Title of host publication||The Neuropsychiatry of Epilepsy, Second Edition|
|Publisher||Cambridge University Press|
|Number of pages||10|
|ISBN (Print)||9780511977145, 9780521154697|
|State||Published - Jan 1 2011|
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