Clinical studies of schizophrenia-like state in epileptic patients

Six subjects who suffered from epileptic seizures followed by a schizophrenia-like state were examined. The mean duration between the onset of seizures and the psychotic state was 13.5 +/- 6.6 years (mean +/- S.D.). Five female subjects had episodic psychotic states and one man had a persistent one. Four subjects had localized temporal EEG abnormalities and the EEGs during psychotic states were different in each subject. During the psychotic state, no seizure was seen in the four subjects, a different seizure frequency in the episodic case and an unchanged frequency in the persistent case. The psychotic features were characterized by K. Schneider's first-rank symptoms. In order to understand the mechanisms of psychotic states, it will be useful to take into consideration the excitatory and inhibitory effects of neurotransmitters on limbic discharges.