A Review on the Pathomechanism of Interictal Psychiatry Comorbidities in Epilepsy

Abstract

Epilepsies, especially mesiotemporal epilepsy in adulthood, are frequently associated with chronic cognitive loss, psychiatry symptoms and conditions. We aim to present the pathophysiology of interictal psychiatric comorbidities interlocked with cognitive loss; severely compromising the quality of life of epilepsy patients. We will present the mechanism of cognitive harm related to interictal spiking; and the abnormalities of brain networks in epilepsy, especially of the default mode network, briefly looking into psychosocial and pharmacology effects, too. In addition to seizures, interictal epileptic activity, mainly in sleep, may exert chronic cognitive harm, increasing the risk for primarily non-cognitive psychotic conditions as well. Interictal spikes and pathological high frequency oscillations curiously resemble normal memory traces; enabling them to “behave” and be mistaken for engrams by the memory process. Epileptic activity impairs the white and grey matter of the brain; likely contributing to brain network changes. The epileptic network changes resemble those seen in non-epileptic psychiatry conditions, offering a network-interpretation of psychiatric comorbidity.