Post-ictal mental disorder

Introduction Patients with mental disorders after an episode may develop autopsy, paralysis, or transient paranoia, hallucinations, etc., usually ranging from a few minutes to several hours.

Cause

The causes of mental depression in patients with epilepsy:

People with epilepsy not only endure physical pain, but also endure mental torture. In this paper, a survey of outpatients with epilepsy found that 25% of people had depressive symptoms. There are many reasons for causing or affecting epilepsy patients with mental depression.

(1) One-sided understanding of epilepsy, lack of relevant knowledge. It is considered to be an incurable disease and requires long-term medication. Patients with epilepsy suffer from long-term lingering disease, long-term unhealed, lose confidence in treatment, lose fun in life, think that the symptoms of seizures are embarrassing, and they feel that they are unacceptable and inferior.

(2) Employment and difficulty in finding objects. The family is not harmonious and interpersonal relationships are tense.

(3) The economic burden is too heavy. In order to seek radical cure, patients seek medical attention and try a variety of methods to bring a serious financial burden to the family.

(4) Not enough attention to psychotherapy. Doctors only pay attention to the therapeutic effect of drugs on patients with epilepsy, ignoring the adverse effects of psychosocial factors on the disease.

(5) Personal psychological quality. Generally, the introverted personality and the patients who are not open-minded are more concurrent.

an examination

Related inspection

Brain CT examination of brain MRI

Automatic symptoms, paralysis, or transient paranoia, hallucinations, etc.

Differential diagnosis

Pre-seizure mental disorder

Behaves as aura or prodromal symptoms. Aura is a partial seizure that occurs before seizures, usually only a few seconds, rarely more than a minute. Seizures in different parts will behave differently, but the same patient will have the same aura before each episode. Prodromal symptoms occur several hours to several days before seizures, especially in children. It is characterized by irritability, nervousness, insomnia, restlessness, and even extreme depression. Symptoms usually end with seizures.

Mental disorder at the time of attack

(1) Automatic symptoms: refers to the turbid state of consciousness that occurs at the time of attack or just after the attack. At this time, the patient can still maintain a certain posture and muscle tension, and complete simple or complicated actions and behaviors in the unconscious. Automated disease is mainly related to the spontaneous electrical activity of the temporal lobe. Sometimes the discharge of the frontal lobe, the cingulate gyrus and the cortex can also produce an automatic disease. 80% of patients have an automatic syndrome of less than 5 minutes and a few can last up to 1 hour. There are often auras before the onset of autopsy, such as dizziness, salivation, chewing movements, somatosensory abnormalities and strangeness. Suddenly become stunned, confused, unconsciously repeating actions such as chewing, pouting, etc., can even complete more complex technical work. After the event, the patient completely forgot what happened during this time.

(2) Shenyou disease: rarer than automatic disease, which lasts for several hours, summer days or even weeks. The degree of disturbance of consciousness is relatively light, the abnormal behavior is more complicated, and it has a certain ability to perceive the surrounding environment, and can also respond accordingly. It is manifested as roaming without a destination, patients can travel far, and can also engage in coordinated activities, such as shopping, simple conversation. Forgotten or difficult after the attack.

(3) state: sudden onset, usually lasts for 1 to several hours, sometimes as long as more than 1 week. The patient presented with a disturbance of consciousness. Accompanied by emotional and sensory impairments, such as horror, anger, etc. can also express emotional apathy, thinking and slow movements.

Interictal mental disorder

Personality changes are more common, mainly in patients with left temporal lobe lesions and major seizures, and are related to factors such as brain organic damage, psychosocial factors, type of seizures, long-term use of antiepileptic drugs, and patient's original personality characteristics. For interpersonal relationships, sensitivity, and thinking, and sticky thinking. A small number of patients with epilepsy may experience memory loss, difficulty in attention, and judgment can be reduced, which may be accompanied by behavioral disorders. These symptoms are more common in patients with secondary epilepsy and long-term, severe epilepsy. Clinically, schizophrenia-like symptoms and emotional symptoms such as anxiety are also seen. It is worth noting that the suicide rate of patients with epilepsy is 4-5 times that of ordinary people, so care should be taken to prevent suicide.

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