Psychosis of Epilepsy

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Psychotic disorders identified in patients with epilepsy are commonly referred to as “psychosis of epilepsy” (POE).in the medical literature The chapter reviews the clinical manifestations of the various forms of psychosis of epilepsy (POE), their potential pathogenic mechanisms, and current management. This is a term applied to a group of psychotic disorders with distinct phenomenology and etiopathogenic mechanisms that are likely to be closely related to the seizure disorder. The chapter describes how episodic psychosis of epilepsy is related to seizure recurrence and remits when seizures are controlled. Psychotic disorders are the least frequent psychiatric comorbidities in patients with epilepsy. They are seen most often in the setting of drug-resistant epilepsy. In contrast to primary psychotic disorders, epilepsy-associated psychoses tend to be more responsive to pharmacotherapy using antipsychotic drugs. Although some antipsychotic drugs can lower the seizure threshold, several antipsychotic drugs, both conventional and atypical, appear to be safe. Their appropriate use should never be withheld for fear of exacerbating seizures in patients with epilepsy. Starting at low dosage and using gradual titration schedules, the risk of seizures can be minimized in both nonepileptic patients and in patients with epilepsy.

Original languageEnglish (US)
Pages (from-to)194-210
Number of pages17
JournalBlue Books of Neurology
Issue numberC
StatePublished - Jan 1 2009
Externally publishedYes

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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