EJMCR. 2020; 4(1): 19-24

Trials and Tribulations of Diagnosing and Managing Psychosis Secondary to Non-Convulsive Epilepsy

Authors: Mahmoud A. Awara, Joshua G. Smalley, Matt Havenga, ManalO. Elnenaei.

ABSTRACT

Background: It is well known that psychotic symptoms can occur as a result of seizure activity in the brain. This can easily be diagnosed in those with recognizable seizures by taking a careful history. However, in the absence of a typical seizure presentation, it is far more challenging to differentiate between an organic and primary psychosis. Case Presentation: We present the case of a 51-year-old female who had a 28-year history of treatment-resistant schizophrenia. She did not report or display any seizure activity, and an extensive investigation was unremarkable. The unusual nature of her psychopathology, which was predominantly visual hallucinations and somatic delusions, and the difficult to treat nature of her symptoms, prompted investigation with Electroencephalograph which demonstrated bilateral temporal lobe epileptic activity. Conclusion: Treatment with divalproex sodium and discontinuation of antipsychotic medication achieved an excellent response, where her visual hallucinations and somatic delusions were both remarkably ameliorated.

Keywords:
Schizophrenia, psychosis, non-convulsive seizures, treatment-resistant


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Trials and Tribulations of Diagnosing and Managing Psychosis Secondary to Non-Convulsive Epilepsy


Authors
Mahmoud A Awara
Associate Professor in Psychiatry, Dalhousie University, Halifax, Canada
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Joshua G Smalley
Resident Physician, Department of Psychiatry, Dalhousie University, Halifax, Canada
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Matt Havenga
Resident Physician, Department of Psychiatry, Dalhousie University, Halifax, Canada
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ManalO Elnenaei
Associate Professor, Chief of Services in Clinical Chemistry, Dalhousie University, Halifax, Canada
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Correspondence to:
. Mahmoud A Awara, Connections Dartmouth; Recovery and Integration Services; NS, Canada; Mahmoud.Awara@nshealth.ca

Publication history
Received 17 May 2019
Accepted 10 Dec 2019
Published online 06 Feb 2020
Published in print 12 Feb 2020

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Pubmed Style

Awara MA, Smalley JG, Havenga M, Elnenaei M. Trials and Tribulations of Diagnosing and Managing Psychosis Secondary to Non-Convulsive Epilepsy. EJMCR. 2020; 4(1): 19-24. doi:10.24911/ejmcr/173-1558018778


Web Style

Awara MA, Smalley JG, Havenga M, Elnenaei M. Trials and Tribulations of Diagnosing and Managing Psychosis Secondary to Non-Convulsive Epilepsy. https://www.ejmcr.com/?mno=49270 [Access: February 21, 2020]. doi:10.24911/ejmcr/173-1558018778


AMA (American Medical Association) Style

Awara MA, Smalley JG, Havenga M, Elnenaei M. Trials and Tribulations of Diagnosing and Managing Psychosis Secondary to Non-Convulsive Epilepsy. EJMCR. 2020; 4(1): 19-24. doi:10.24911/ejmcr/173-1558018778


Vancouver/ICMJE Style

Awara MA, Smalley JG, Havenga M, Elnenaei M. Trials and Tribulations of Diagnosing and Managing Psychosis Secondary to Non-Convulsive Epilepsy. EJMCR. (2020), [cited February 21, 2020]; 4(1): 19-24. doi:10.24911/ejmcr/173-1558018778


Harvard Style

Awara, M. A., Smalley, . J. G., Havenga, . M. & Elnenaei, . M. (2020) Trials and Tribulations of Diagnosing and Managing Psychosis Secondary to Non-Convulsive Epilepsy. EJMCR, 4 (1), 19-24. doi:10.24911/ejmcr/173-1558018778


Turabian Style

Awara, Mahmoud A., Joshua G. Smalley, Matt Havenga, and ManalO. Elnenaei. 2020. Trials and Tribulations of Diagnosing and Managing Psychosis Secondary to Non-Convulsive Epilepsy. European Journal of Medical Case Reports, 4 (1), 19-24. doi:10.24911/ejmcr/173-1558018778


Chicago Style

Awara, Mahmoud A., Joshua G. Smalley, Matt Havenga, and ManalO. Elnenaei. "Trials and Tribulations of Diagnosing and Managing Psychosis Secondary to Non-Convulsive Epilepsy." European Journal of Medical Case Reports 4 (2020), 19-24. doi:10.24911/ejmcr/173-1558018778


MLA (The Modern Language Association) Style

Awara, Mahmoud A., Joshua G. Smalley, Matt Havenga, and ManalO. Elnenaei. "Trials and Tribulations of Diagnosing and Managing Psychosis Secondary to Non-Convulsive Epilepsy." European Journal of Medical Case Reports 4.1 (2020), 19-24. Print. doi:10.24911/ejmcr/173-1558018778


APA (American Psychological Association) Style

Awara, M. A., Smalley, . J. G., Havenga, . M. & Elnenaei, . M. (2020) Trials and Tribulations of Diagnosing and Managing Psychosis Secondary to Non-Convulsive Epilepsy. European Journal of Medical Case Reports, 4 (1), 19-24. doi:10.24911/ejmcr/173-1558018778


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