[Psychiatric aspects of psychomotor epilepsy]

Historical myths about inevitable behavioural and cognitive consequences of epileptic disorders still provide patients and their families with unfounded fears leading to self-fulfilling prophecies of psychosocial and mental deterioration. Psychomotor attacks are subjectively experienced disruptions in the continuity of life and self-perception which it will be difficult to integrate into the organization of daily life. These facts must be kept in mind when epileptic patients present psychological problems. The most common features of neuropsychological and psychosocial problems are discussed and the importance of combining optimal antiepileptic medication with psychotherapy is underlined. Coexisting epileptic and psychogenic symptoms being difficult to disentangle patients presenting both may be exposed to unfortunate alternating therapeutic strategies by ambitendent therapists. Careful observation without overt attention combined with assisting the patient in obtaining more autonomy and self management appear to be the best policy to stop psychogenic fits.