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Thirteen patients met the criteria for a postictal psychiatric event during the 18 month study period,10 presenting as postictal psychotic events and three as postictal nonpsychotic events.The annual incidence of postictal psychiatric events at our monitoring unit for 1988 was 7.8%,6.4% presenting as postictal psychotic events and 1.4%as postictal nonpsychotic events.Seven patients had their first ever postictal psychiatric event during the monitoring study.In 12 of the 13 patients,the postictal psychiatric events mimicked well-defined psychiatric entities of shorter duration(mean 66.5 hours);they appeared 12 to 72 hours after the last seizure and remitted spontaneously or with the use of low dose psychotrophic medication.No significant differences in EEG, neuroradiologic,psychiatric,medical,or psychosocial data were found between the patients with postictal psychiatric events and a group of 13 age-matched control patients.Followup data of comparable duration were available in nine patients with postictal psychiatric events and nine controls.Psychiatric events were reported more frequently by patients with postictal psychiatric events than by control patients(P=.03).In three patients,postictal psychiatric events converted to interictal events.These findings suggest that monitoring studies increase the risk for postictal psychiatric events,which neurologists need to be familiar with,as they represent important morbidity associated with these studies. |
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