Gli eventi psichiatrici in corso di epilessia

Abstract

Introduction

The prevalence of psychiatric events in epilepsy remains controversial and difficult to define. Psychiatric disorders are often misdiagnosed in patients with epilepsy, and they may be evaluated differently by neurologists and psychiatrists.

Materials and methods

We conducted a search of PubMed and Embase databases using the keywords “epilepsy” and “psychiatry” or “psychiatric”. The articles that were in our opinion most significant were selected for this review.

Results

Every psychiatric event that occurs in a patient with epilepsy should be classified on the basis of its temporal relation with the seizures; unlike most psychiatric disorders, those associated with epilepsy are not chronic conditions. Psychotic episodes may occur in epilepsy, but they rarely reflect the presence of a chronic psychotic disorder. In other cases, the relationship between epileptic seizures and psychotic episodes is one of alternating events (forced normalization). Depression is the most common psychiatric disorder in patients with epilepsy, although in most cases it is mild and does not require drug therapy. Mood and anxiety disorders are also commonly associated in these patients. Epilepsy is sometimes associated with specific changes in the personality although currently available data are not sufficient to justify the term “epileptic personality”. In patients with epilepsy (but also in those without epilepsy) Psychogenic Non-Epileptic Seizures (PNES) can also occur, and they can often be differentiated from epileptic seizures only by videoEEG findings.