This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Acute Psychosis After Seizure Control in Seven Patients

Ann Pakalnis, MD; Miles E. Drake, Jr, MD; Kuruvilla John, MBBS; J. Blake Kellum, MD

Arch Neurol. 1987;44(3):289-292.

Abstract
• An antagonistic relationship between psychosis and seizures has been described in some patients and is sometimes termed "forced normalization." We saw seven epileptic patients without a previous psychiatric history, who developed acute psychotic states on establishment of seizure control and normalization of previously abnormal electroencephalograms with frank epileptiform activity. A possible hypothetical relationship between psychosis and epilepsy regarding the mesolimbic dopaminergic system and kindling of this system with epileptic discharge in temporal-limbic circuits could induce a florid psychotic state in some patients. This biochemical relationship to schizophrenia with heightened dopamine activity would also easily explain the amelioration of acute psychotic activity in our seven patients with neuroleptic agents and their antagonism of this increased dopaminergic outflow state.

Author Affiliations
From the Department of Neurology, The Ohio State University College of Medicine, Columbus.

Footnotes
Accepted for publication Nov 10, 1986.

Presented in part at the 38th Annual Meeting of the American Academy of Neurology, New Orleans, May 1, 1986.

Reprint requests to Department of Neurology, The Ohio State University College of Medicine, 440 Means Hall, 1655 Upham Dr, Columbus, OH 43210 (Dr Pakalnis).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

fMRI Activity Correlated With Auditory Hallucinations During Performance of a Working Memory Task: Data From the FBIRN Consortium Study
Wible et al.
Schizophr Bull 2009;35:47-57.
ABSTRACT | FULL TEXT  

Alternating and Postictal Psychoses: Review and a Unifying Hypothesis
Sachdev
Schizophr Bull 2007;33:1029-1037.
ABSTRACT | FULL TEXT  

Prevalence and clinical characteristics of postictal psychiatric symptoms in partial epilepsy
Tombini et al.
Neurology 2004;63:1542-1543.
FULL TEXT  

Diagnosis and Management of Depression and Psychosis in Children and Adolescents With Epilepsy
Kanner and Dunn
J Child Neurol 2004;19:S65-S72.
ABSTRACT  

Diagnosis and Management of Depression and Psychosis in Children and Adolescents With Epilepsy
Kanner and Dunn
J Child Neurol 2004;19:S65-S72.
ABSTRACT  

Schizophrenia-Like Psychosis and Epilepsy: The Status of the Association
Sachdev
Am. J. Psychiatry 1998;155:325-336.
ABSTRACT | FULL TEXT  

Forced Normalization
Vaillancourt
Arch Neurol 1988;45:138-138.
ABSTRACT  

Forced Normalization-Reply
Pakalnis et al.
Arch Neurol 1988;45:138-139.
ABSTRACT  

Epilepsy, Psychosis, and Forced Normalization
Schiffer
Arch Neurol 1987;44:253-253.
ABSTRACT