Late-onset schizophrenia with epileptiform discharge

Area of Science:

• Neurology
• Psychiatry
• Clinical Neurophysiology

Background:

• Late-onset psychosis is a challenging clinical presentation.
• Epileptiform discharges can manifest in psychiatric conditions.
• Distinguishing organic from functional psychosis is crucial.

Purpose of the Study:

• To report a unique case of late-onset psychosis associated with epileptiform discharges.
• To investigate the efficacy of sodium valproate in managing such a condition.
• To explore potential organic etiologies for late-onset psychosis.

Main Methods:

• Case report of a 51-year-old woman with abrupt onset psychosis.
• Electroencephalography (EEG) to detect epileptiform discharges.
• Neuroimaging (CT, MRI, SPECT) and cerebrospinal fluid analysis.
• Treatment with sodium valproate and monitoring of clinical and EEG changes.

Main Results:

• The patient presented with auditory and somatic hallucinations, delusions, and loosening of associations.
• EEG revealed diffuse sharp and slow wave complexes, indicating epileptiform discharges.
• Neuroimaging and CSF studies were unremarkable.
• Epileptiform discharges resolved within 10 days of sodium valproate treatment.
• Complete clinical improvement followed EEG normalization.

Conclusions:

• Late-onset psychosis can be associated with epileptiform discharges.
• Sodium valproate may be an effective treatment for psychosis with epileptiform abnormalities.
• The etiology remains unclear, suggesting potential underlying organic factors.