Prevalence and clinical characteristics of postictal psychiatric symptoms in partial epilepsy

TLDR

The postictal period is defined as the 72 hours following a seizure. The study aims to determine the prevalence and clinical features of postictal psychiatric and cognitive symptoms in refractory partial epilepsy patients and assess whether interictal symptoms worsen during the postictal period. The authors surveyed 100 of 114 consecutive refractory partial epilepsy patients over three months with a 42‑item questionnaire to assess postictal psychiatric and cognitive symptoms and their worsening relative to interictal baseline. Postictal psychiatric symptoms were common, with an average of 5.9 PPS and 2.8 PCS per patient, most patients experiencing multiple PPS, 38 patients reporting worsened interictal symptoms, and a history of depression or anxiety associated with higher rates of postictal depression, anxiety, and psychosis.

Abstract

S: To identify the prevalence and clinical characteristics of postictal psychiatric (PPS) and cognitive (PCS) symptoms in patients with refractory partial epilepsy and to investigate whether interictal psychiatric and cognitive symptoms worsened in severity during the postictal period.Using a 42-item questionnaire, the authors determined the prevalence and clinical characteristics of PPS and PCS that occurred after >50% of seizures in 100 of 114 consecutive patients with refractory partial epilepsy during a 3-month period. The postictal period was defined as the 72 hours that followed a seizure. The prevalence of all interictal psychiatric and cognitive symptoms was identified and the frequency with which they worsened postictally determined.A mean of 2.8 +/- 1.8 PCS (median = 3) and 5.9 +/- 5.3 PPS (median = 5) was identified, which included postictal symptoms of depression (PSD) in 43 patients, anxiety (PSA) in 45, postictal psychotic symptoms (PIP) in 7, hypomanic symptoms in 22, neurovegetative symptoms in 52, and fatigue in 37. Most patients experienced more than one type of PPS. Independently of the occurrence of PPS, 38 patients reported a worsening of interictal psychiatric and cognitive symptoms postictally. A history of depression and anxiety significantly increased the number of PSD, PSA, and PIP.Postictal psychiatric symptoms are common among patients with refractory partial epilepsy, and the severity of interictal psychiatric and cognitive symptoms commonly worsens during the postictal period.