Models for understanding the antagonism between seizures and psychosis

1. The relationship between seizures and psychosis is reviewed using incidence and association studies, and experimental models of kindling and behavioral sensitization. 2. While there are conflicting data on the association of psychopathology with epilepsy, studies illustrating the antagonism between seizures and psychosis are examined along with the phenomenon of "Forced Normalization". 3. Electrical kindling of the amygdala provides a model of temporal lobe epilepsy while pharmacologic kindling/behavioral sensitization or dopaminergic kindling provides a model for psychosis. 4. A model explaining both the etiology and the reciprocal nature of seizures and psychosis in temporal lobe epilepsy is developed. Preictal and interictal spikes kindle both proconvulsive and inhibitory pathways of seizure expression and behaviorally relevant limbic systems. That system currently expressive, either seizure or psychosis, while under high synchronous drive would tend to fail allowing for the emergence of the opposing system.