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Menstrual epileptoid psychosis in an adolescent girl

An adolescent girl with a previous history of trance-like states and a strong family history of epilepsy developed a pattern of recurrent brief psychotic episodes. These episodes seemed to coincide with her monthly menstrual periods, and after four to seven days of bizzare, catatonic behavior, she would return to a normal state. These episodes have been virtually eliminated by maintenance of a therapeutic blood level of phenytoin. The case is discussed in the light of the complex interrelationship of seizures, menstrual hormonal changes, and behavior.

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