Women with Epilepsy: A Handbook of Health and Treatment Issues (Chapter 17)

Psychiatric complications in epilepsy (Excerpt)

Laura Marsh

Introduction

Almost everyone experiences emotions such as depression and anxiety. Often, people will ‘explain away’ feelings of depression or anxiety as understandable reactions to difficult circumstances. While this is sometimes the case, emotional experiences in women and men with epilepsy can also be a biological reaction to the epilepsy itself. In fact, doctors now recognize that epilepsy is associated with a number of emotional and behavioral symptoms.

How often people with epilepsy experience psychiatric disturbances is not clear; reports tend to vary according to where the study was conducted. Studies based on patients from a community practice tend to show lower rates of psychiatric disturbance, whereas there is a higher rate among people with medically uncontrolled seizures seen at university-based epilepsy clinics. Nonetheless, epilepsy, like other conditions involving the brain, can be associated with psychiatric symptoms. These symptoms can have worse effects on well-being and functioning than the seizures themselves. In addition, psychiatric symptoms or illness can worsen epilepsy, as it is well recognized that emotional states can trigger epileptic seizures.

One of the most important aspects in the assessment of psychiatric symptoms in epilepsy is clarification of when symptoms occur in relation to the different phases of seizure activity; that is, whether the symptoms occur just before the seizure (the prodromal phase), during the seizure (the ictal phase), after the seizure (the postictal stage), or between seizures (the interictal phase). The cause of the psychiatric symptoms will be different depending upon whether they coincide with abnormal electrical activity during the seizure or are unrelated to seizures. Treatment approaches are also different

-- Excerpted from "Women with Epilepsy: A Handbook for Health and Treatment Issues" edited by Martha J. Morrell, MD and Kerry L. Flynn, M.A. Published by Cambridge University Press, 2003. It is available for purchase in our marketplace.