Complex partial seizures presenting as a psychiatric illness

A 36-year-old woman was treated for a wide variety of psychiatric illnesses over a span of two decades before a diagnosis of complex partial seizures was made. Her history included poor impulse control, rage attacks, multiple suicide attempts, rapid mood swings, depression, and psychotic episodes. Bulimia, panic attacks, severe obsessive-compulsive symptoms, and multiple somatic complaints were also present. In retrospect, these symptoms could be attributed to complex partial seizures with cognitive and affective symptomatology, automatisms, and psychosensory symptoms, and were controlled by anticonvulsant medications. Therefore, so-called "purely" psychiatric disorders should not be diagnosed before a diagnosis of limbic epilepsy (however, this might be labeled, e.g., complex partial seizure, psychomotor seizure, psychical seizure, or temporal lobe epilepsy) has been considered.