Hostname: page-component-77c89778f8-7drxs Total loading time: 0 Render date: 2024-07-19T23:07:10.159Z Has data issue: false hasContentIssue false

First psychotic episode on the fifth decade? Differential diagnosis of psychotic symptoms, about a case

Published online by Cambridge University Press:  23 March 2020

P. Manzur Rojas*
Affiliation:
Centro de Salud Mental de Cartagena, Psiquiatria, Cartagena, Spain
P. Botias Cegarra
Affiliation:
Centro de Salud Mental de Cartagena, Psiquiatria, Cartagena, Spain
A.L. Gonzalez Galdamez
Affiliation:
Centro de Salud Mental de Cartagena, Psiquiatria, Cartagena, Spain
M.I. Ibernon Caballero
Affiliation:
Centro de Salud Mental de Cartagena, Psiquiatria, Cartagena, Spain
M.R. Raposo Hernandez
Affiliation:
Centro de Salud Mental de Cartagena, Psiquiatria, Cartagena, Spain
A. Sanchez Bahillo
Affiliation:
Centro de Salud Mental de Cartagena, Psiquiatria, Cartagena, Spain
A. Belmar Simo
Affiliation:
Centro de Salud Mental de Cartagena, Psiquiatria, Cartagena, Spain
M.A. Carrillo Cordoba
Affiliation:
Centro de Salud Mental de Cartagena, Psiquiatria, Cartagena, Spain
*
* Corresponding author.

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The postictal psychosis is a psychotic disorder that begins shortly after a crisis. Most often it affects patients with partial epilepsy and especially those with temporal lobe epilepsy. The postictal psychosis according to several publications can occur in up to 25% of patients with epilepsy. The psychotic disorder usually occurs within 24–48 hours after, be transient, with good response to treatment with antipsychotics and complete remission of psychotic symptoms. This case is for a woman of 58 years diagnosed with structural epilepsy after brain abscess left temporal intervened in childhood. The patient is being followed by neurology for complex partial seizures with secondary generalization in anti-epileptic treatment. The patient has previous studies of EEG, video EEG and brain MRI, evidence involvement of temporal lobe and hippocampus. The patient is brought to the emergency room after episode of sensory aphasia, unconsciousness and tonic-clonic limb movements, decreasing with diazepam. The patient, during the stay under observation, has auditory hallucinations, that generate anxiety must initiate being him quetiapina and clonazepam orally, yielding partially psychotic disorder, acute intracranial lesions are discarded and the patient is admitted by neurology. The evolution of psychotic disorder with antipsychotic down in a few weeks remaining asymptomatic. Epileptic psychosis is more common in refractory epilepsy. In all cases, you should make a joint approach between psychiatry and neurology, usually they have good response to antipsychotics.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EV1405
Copyright
Copyright © European Psychiatric Association 2016
Submit a response

Comments

No Comments have been published for this article.