Possible Precursor to Epilepsy

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There is not much of a surprise when you hear Epilepsy and Psychiatric Disorders are connected. People would expect that due to receiving the diagnosis or if there was a structural abnormality that may interfere with the brain’s normal processing. There has been a lot of research showing a clear comorbidity between the two. A thought I have always held onto and had not looked into further was if psychological conditions could serve as precursors to Epilepsy. A member reached out to me personally asking if I could do a little research which ended up dabbling into my own questions. I will present to you quick synapses and links to research articles that may make you begin to ask questions.


 

  • Schizophrenia-like Psychosis and Epilepsy: The Status of the Association

Source: https://www.ncbi.nlm.nih.gov/pubmed/9501741

Date: 1998 (yes, technically deemed outdated – but for reference purposes)

What is it saying: Epilepsy may be related to schizophrenia-like psychosis due to structural brain abnormalities (e.g. cortical digenesis or diffuse brain lesions). Seizures may modify the presentation pf psychosis and psychosis may modify the presentation of seizures.

  • Bidirectional Relation Between Schizophrenia and Epilepsy: A population-based Retrospective Cohort Study

Source: http://onlinelibrary.wiley.com/doi/10.1111/j.1528-1167.2011.03268.x/full

Date: September 19, 2011

What is it saying: Incidence of Epilepsy is higher in those with Schizophrenia and Schizophrenia patients have a higher incidence of Epilepsy. Thus, the two conditions may share a common cause

  • The Secondary Schizophrenias

Source: http://onlinelibrary.wiley.com/doi/10.1002/9781444327298.ch9/summary

Date: March 08, 2011

What is it saying: Epilepsy may/can cause Schizophrenic-like signs and symptoms which can lead to Schizophrenia-like psychosis

  • Schizophrenia Like Psychosis in Patients with Epilepsy Case Report

Source: http://www.ucms.com.np/journals/vol2/SCHIZOPHRENIA%20LIKE%20PSYCHOSIS%20IN%20PATIENTS%20WITH%20EPILEPSY%20CASE%20REPORT.pdf

Date: 2013

What is it saying: Epilepsy and Schizophrenia are both due to altered cerebral functioning and their history is often connected. Focuses on generalized tonic-clonic seizures presenting with schizophrenia-like symptoms

  • Recurrent Schizophrenia-like Psychosis as First Manifestation of Epilepsy: A Diagnostic Challenge in Neuropsychiatry

Source: https://www.dovepress.com/recurrent-schizophrenia-like-psychosis-as-first-manifestation-of-epile-peer-reviewed-article-NDT

Date: May 03, 2010

What is it saying: Studies have been done on Schizophrenia-like psychoses in Epilepsy since 1950s. It has been well documented that Epilepsy may be associated with psychotic disorders but, less widely recognized that the relapsing psychotic phenomena may be the first and only symptom of Epilepsy. This case study was focused on two patients specifically with an initial diagnosis of Bipolar Affective Disorder and Schizophrenic Psychosis. Treatment began using more epileptic tactics and during a follow-up, patients were free of Epilepsy and psychotic symptoms.

  • Epilepsy, Suicidality, and Psychiatric Disorders: A Bidirectional Association

Source: http://onlinelibrary.wiley.com/doi/10.1002/ana.23601/full

Date: August 07, 2012

What is it saying: Psychosis, depression, and anxiety significantly increase before Epilepsy diagnosis and after as well as one year after diagnosis. This shows that an underlying pathophysiological mechanism seen in both that lowers the seizure threshold and increases risk for psychiatric disorders

  • Hospitalization for Psychiatric Disorders Before and After the Onset of Unprovoked Seizures/Epilepsy

Source: http://www.neurology.org/content/78/6/396.short

Date: January 25, 2012

What is it saying: The risk of developing an unprovoked epileptic seizure is highest less than 2 years before and up to 2 years after a first psychiatric diagnosis (includes: depression, bipolar disorder, psychosis, anxiety disorders, and suicide attempts). Higher prevalence with those having depression and psychosis.


Wait, what does this all mean?

While yes, this is open for individual interpretation to some degree – you cannot deny there is a strong correlation between psychiatric conditions and psychosis with Epilepsy. At times, it appears this may be the initial or only sign of Epilepsy and could serve as a precursor to an eventual epileptic diagnosis for some people. Unfortunately, there is a gap between psychiatry and neurology that may allow some people to fall between the lines to be conveniently pushed into one section or another. I believe that this is what also makes Psychogenetic Non-Epileptic Seizures (PNES) so difficult and avoided. What if PNES is a soft-name for a precursor to  Epilepsy? What if we can catch Epilepsy through psychiatric disorders before the onset of a seizure? For me, this has opened up a lot of questions and I hope it made you think too. If you feel as though your psychiatric diagnosis does not quite fit your situation, do not be afraid to question your doctor. If you feel as though your PNES may be more epileptic, again, question them. Of course, this situation may not be for everyone, but questions get answered. Don not be afraid, advocate!


What are your thoughts or opinions? Did this get you thinking?

Share in the comments below!

 

11 comments

  1. Amanda says:

    EPIPHANY–Wow! This has me thinking so much my head is spinning(and not bc I’m having a seizure!). I have had generalized Toni-clonic since forever. Throughout my life I have bounced back and forth between diagnosis such as depression,anxiety and borderline personality. I don’t nessacroly believe that one causes the other. Correlation does not infer causation. HOWEVER, AEDs might be the link. Think of Keppra, it cause psychosis (aka keppra crazies). Even more persuasive is benzodiazepines!! Often prescribed as AEDs but when you take it their is a high (similar to the high in bi-polar 1&2). Then as it wears off you “come down”. Making the difference in emotions from high to low much more distinct and intense. Maybe the AEDs facilitate psychiatric symptoms?? Love this article. Thanks for writing it .

    • Samantha says:

      I am so glad you enjoyed this article! You have a very plausible case. Many AEDs can mimic psychological conditions. Keppra alone has a warning that it can mimic/cause personality disorder as well as cause depression and anxiety. So your thought would not be wrong in saying AEDs facilitate or perhaps enhance psychiatric symptoms. I feel as though there may be a deeper connection that we could be unaware of. The brain is a massive mystery in some aspects. I found all these articles absolutely fascinating and hope to bring some interesting conversations to the table. Maybe some new ideas or thought processes will emerge; who knows! Thank you for contributing, it is always welcomed!

  2. Theresa says:

    Hi Samantha, this is very interesting. My son, age 22, had his first grand mal seizure at 19 and his second this past July at 21. He is now on anti-seizure meds. What I find interesting is that he doesn’t suffer from mental illness but his older sister age 24 has Borderline and his younger brother age 16 is being treated for anxiety/depression. Tommy’s seizures are triggered by lift sensitivity but we definitely have mental illness in our family. Thank you for sharing.

    • Samantha says:

      Glad you found this interesting as I did as well! Definitely makes you think about some things from a different perspective. Again, there can be many different interpretations on this data and of course everyone has a different background but it makes you wonder if there is a deeper link that we are all missing.

  3. Luisasot says:

    whoa1h this blog is great i love reading your posts. Keep up the great work! You know, a lot of people are looking around for this information, you can aid them greatly.

    • Samantha says:

      Thank you! My goal is trying to form an effective site with various information on Epilepsy and Seizure Disorders to help further educate people or help those who are new to this diagnosis. Glad you stopped by!

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