Temporal lobe epilepsy masquerading as psychosis--a case report and literature review

The psychoses of epilepsy are well recognized complications of seizure disorders, diagnosed easily from the history. However, in the absence of recognized seizures, the diagnosis can be challenging. We present a 27-year-old female, who suffered a treatment refractory psychosis for 6 years. She did not report, or display, any seizure activity, and extensive investigation was unremarkable. The onset of new symptoms prompted a repeat work-up which clinched the diagnosis of psychosis of epilepsy. Treatment with Lamotrigine and Amisulpiride achieved an excellent response, and she has remained symptom free for 7 months. We conclude with a brief literature review.