Status epilepticus and psychosis: Lessons from SEEG

Area of Science:

• Neurology
• Neuroscience
• Psychiatry

Background:

• Psychotic manifestations are a known feature of non-convulsive status epilepticus (NCSE), particularly of temporal origin.
• Diagnosing psychiatric symptoms in NCSE presents significant challenges.
• Previous research on NCSE and its psychiatric aspects has rarely utilized stereotactic-EEG (SEEG).

Purpose of the Study:

• To explore the anatomical substrate of psychiatric manifestations in NCSE using SEEG.
• To investigate the link between limbic system seizures and emotional/behavioral disturbances.

Main Methods:

• Review of rare cases utilizing stereotactic-EEG (SEEG) recordings in patients with non-convulsive status epilepticus (NCSE).

Main Results:

• SEEG studies have identified the anatomical basis for specific NCSE-related psychotic symptoms like hallucinations and delusions.
• SEEG demonstrated that seizures in the temporal and frontal limbic systems can cause significant emotional and behavioral changes.
• The post-ictal period was identified as the origin for some of these manifestations.

Conclusions:

• Stereotactic-EEG (SEEG) provides valuable insights into the neuroanatomical underpinnings of psychiatric symptoms in non-convulsive status epilepticus (NCSE).
• SEEG confirms that limbic system seizures are associated with profound emotional and behavioral disturbances in NCSE patients.