Incidence

Fifty-one (2%) out of 2905 patients with epilepsy treated at Kansai Regional Epilepsy Center experienced postictal psychoses that were not artificially induced (Table 9.1). It is difficult to compare our data with previous studies, as they are either multiple case reports (Lancman et al., 1994; Levin, 1952; Logsdail and Toone, 1988; Savard et al., 1991; Umbricht et al., 1995) or based on observations during

Table 9.1. Incidence of epileptic psychosis

Patients with psychotic disorder

177

(6%)

Postictal psychosis*

51

(2%)

Acute interictal psychosis*

75

(3%)

Chronic psychosis*

57

(2%)

Patients without psychotic disorder

2728

(94%)

Total

2905

* Six patients experienced both postictal and interictal psychoses.

Note:

* Six patients experienced both postictal and interictal psychoses.

the seizure monitoring in preparation for epilepsy surgery (Devinsky et al., 1995; Kanner et al., 1996). However, our finding seems to have a certain reliability, because the prevalence of interictal psychosis in patients with epilepsy in the current study (5%) agreed well with that seen in other specialized epilepsy clinics (4-9%) (Edeh and Toone, 1987; Mendez et al., 1993; Onuma et al., 1995). The prevalence of postictal psychosis in patients with temporal lobe epilepsy (11%) proved to be far higher than that in the general epilepsy population. Kanner et al. (1996) reported that the annual incidence of postictal psychiatric events, including post-ictal psychosis, at their monitoring unit was 7.8%. Seven out of the 13 patients in their series had their first-ever postictal psychiatric event during the monitoring study, therefore, at most only 4% experienced a truly spontaneous postictal psychiatric event. Considering that their study was limited to patients with symptomatic localization-related epilepsy, this figure is approximate to ours.

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