Acute and chronic epileptic psychosis
Content:
- Acute epileptic psychosis
- Chronic epileptic psychosis
What is epileptic psychosis?
Epileptic psychosis (acute or chronic) is a common clinical manifestation of epilepsy. Acute psychoses are usually transient. Chronic ones can last for a year, and are more common in the later stages of the disease.
According to various authors, epileptic psychoses occur in 2.5-5% of patients. The duration of the illness affects the likelihood of psychosis. In the more distant stages of the disease, the likelihood of psychosis increases. Acute psychoses are more common in patients with epilepsy than chronic ones.
Acute epileptic psychosis
Acute epileptic psychosis can last as long as several days, so sometimes it can last up to several weeks and does not depend on seizures and states of confusion. These psychotic manifestations, often in the form of an acute paranoid reaction, are inherent in patients with temporal lobe epilepsy during the period of spontaneous remission, during the period of taking anticonvulsants.
Acute epileptic mental disorders, in turn, are divided into psychoses with dullness and without dullness of consciousness. Psychoses with dimness of consciousness means oneiroid or twilight states.
Twilight states are not associated with seizures; as a rule, they last for several days. On the eve of the seizure, the patient has autonomic disturbances, accompanied by unaccountable fear. Post-seizure states are more common, more prolonged and complex in structure. They are accompanied by hallucinations, aggression, emotional tension, movement disorders.
Oneiric conditions are relatively rare. During periods of epileptic oneyroid, patients experience auditory and visual hallucinations of a fantastic nature. The patient perceives the world around him in a distorted way, like heaven or hell, catastrophes and cataclysms or mass festivities are seen around. At the same time, the patient himself can position himself as God, an apostle or any other powerful real or fictional character.
In such a state, the patient feels his significance, solves the global problems of mankind, communicates with the mighty of this world. Psychoses are manifested by horror, anger, malice or delight, ecstasy, euphoria. Movement disorders can manifest themselves as sharp excitement and lethargy. Unlike the twilight state, the patient perceives illusory disorders, but absolutely amnesifies the real situation.
Acute epileptic disorders without stupefaction are divided into two groups: affective psychoses and acute paranoids. Acute affective disorders are expressed by manic and depressive states. They are represented by dysphoric, depressive states, sometimes accompanied by vital melancholy, anxiety, agitation, and hypochondriacal delirium. Mania for cheerful inactivity can be replaced by a desire for activity.
Acute paranoid states are unstable in content and are expressed in figurative (sensual) delirium. The patient sees threat and danger everywhere, in peaceful speeches he hears a dirty trick, ridicule, abuse.
Chronic epileptic psychosis
Chronic epileptic psychoses are poorly understood today, they are less common than acute mental disorders. This term is commonly applied to disorders with hallucinatory and delusional symptoms. The following manifestations of chronic psychosis are known: hallucinatory-paranoid syndrome, paranoid, paranoid, Kandinsky's syndrome.
The hallucinatory-paranoid state is characterized by pseudo hallucinations, visual and auditory hallucinations. At the same time, the perception of one's own body and the surrounding reality is distorted. The patient develops delusional ideas, self-accusation, persecution mania. The seizures are inhibited and recede before the onset of the attack of psychosis.
Paranoid syndrome is accompanied by delusional ideas of a good-natured or aggressive nature. The patient thinks that he is God, a saint or a superman and can control the fate of people and the world. Or the patient sees a threat in everything, a catch, the idea of persecution by spies, secret organizations does not leave him.
The paranoia syndrome proceeds without hallucinations, while the patient has delusions of reformism, ideas of an inventive nature. The patient has a wary, suspicious attitude towards others, it seems that they envy him and interfere with the implementation of his ideas. Sometimes patients declare that they are sick with various diseases and require examination and treatment.
Kandinsky's syndrome is characterized by pseudo-hallucinations, systematized delusions, a symptom of openness (the patient does not harbor thoughts).
However, to this day, the relationship and pattern between epilepsy and psychosis has not been precisely defined.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
