Psychotic symptoms in childhood epilepsy--an electroencephalographic study

To investigate the significance of EEG findings relating to the appearance of psychic symptoms in epileptic children, a clinicoelectroencephalographic study was undertaken on 15 cases with psychotic episodes. 1) Psychotic episodes with hallucination and/or illusion were observed, though rarely, in childhood epilepsy. These seemed liable to occur in temporal lobe epilepsy. 2) Three of four patients in the hallucination and illusion group showed frequent epileptic discharges. However, no distinct relation existed between seizure discharges and psychotic episodes. 3) Eight of 11 patients in the dysphoria and excitement group were secondary generalized epilepsy. 4) In the dysphoria and excitement group, psychotic episodes occurred either as a result of the increase in epileptic discharges or conversely as a result of the suppression of epileptic discharges. The former was more frequent. Epileptic discharges tended to be suppressed in the Lennox syndrome and allied conditions relating to psychotic episodes. 5) A forced normalization-like phenomenon mostly resulted from the marked suppression of diffuse slow spike-waves. However, a complete suppression of epileptic discharges was not always noted.