Abstract
Epileptic seizures may be misdiagnosed if they manifest as psychiatric symptoms. We report three female patients with no preexisting history of epilepsy that were unsuccessfully treated as primary psychiatric disorder: one patient was initially diagnosed with somatization and Ekbom syndrome; the second was referred to psychiatrist due to mood instability and visual hallucinations; and the third one was referred for anxiety and hallucinations related to sleep. A carefully taken medical history clarified diagnoses of epilepsy. None of the patients responded to medications aimed at treating psychiatric symptoms, and all the patients had favorable response to antiepileptic treatment. These cases illustrate that epileptic patients may experience nonconvulsive seizures that might be misdiagnosed as primary psychiatric disorder.
Highlights
Chadwick (1994) recommends defining an epileptic seizure as “an intermittent, stereotyped disturbance of consciousness, behavior, emotion, motor function or sensation that on clinical grounds is believed to result from cortical neuronal discharge” [1]
Epileptic phenomena associated with some experiences or presentations similar to psychiatric symptoms may be misinterpreted as primarily mental disorder
We found some rare case reports describing focal epilepsy developed after soft tissue lesions of hands, with start of seizures in the injured hand
Summary
Chadwick (1994) recommends defining an epileptic seizure as “an intermittent, stereotyped disturbance of consciousness, behavior, emotion, motor function or sensation that on clinical grounds is believed to result from cortical neuronal discharge” [1]. This definition conveys three important principles: (i) the core presenting feature, the seizure, is a transient abnormality of neurological function that is highly uniform from one episode to the ; (ii) the diagnosis depends primarily on clinical judgment; and (iii) the underlying mechanism of an epileptic seizure is an abnormal cortical discharge. Epileptic phenomena associated with some experiences or presentations similar to psychiatric symptoms may be misinterpreted as primarily mental disorder
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