Abstract
Patients with epilepsy may experience psychiatric symptoms preceding the seizure (pre-ictal), following the seizure (post-ictal), independently of seizure occurrence (interictal), or as an expression of the seizure (ictal). Compared to interictal, peri-ictal psychiatric symptoms are less investigated and recognized. However, they contribute substantially to disability and distress among people with epilepsy.The relationship between interictal and periictal symptoms is still largely unknown but it seems that they are intimately related in epilepsy. Greater appreciation and understanding of the periictal period is clinically important, providing a model for understanding basic mechanisms underlying mood and thought disorders and the substrates of cognition, volition, emotion, and consciousness.The present paper is aimed at reviewing major psychiatric symptoms that may occur around the ictus with special attention to clinical descriptions and relationships with interictal psychopathology.
Highlights
Patients with epilepsy may experience a number of psychiatric and cognitive symptoms or behavioral manifestations during the period around the ictus
The practicality of classifying behavioral symptoms according to their temporal relation to seizure occurrence has been recognized for a long time (Fig. 1). These phenomena have been well described by Gowers [15] and Jackson [17] and Kraepelin [26] and Bleuler [5] recognized their occurrence in epilepsy
Among all behavioral manifestations, periictal symptoms still remain the least recognized by clinicians and the least investigated in systematic research
Summary
Patients with epilepsy may experience a number of psychiatric and cognitive symptoms or behavioral manifestations during the period around the ictus. They are obviously unique to patients with epilepsy and are referred to as peri-ictal symptoms [11,24]. The practicality of classifying behavioral symptoms according to their temporal relation to seizure occurrence has been recognized for a long time (Fig. 1) These phenomena have been well described by Gowers [15] and Jackson [17] and Kraepelin [26] and Bleuler [5] recognized their occurrence in epilepsy. Monaco / Ictal and peri-ictal psychopathology ical features and differential diagnosis with interictal psychopathology
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