RESUMO
We investigated anatomic alterations and lateralization effect in the mesial temporal lobe structures (amygdala and hippocampus) in epileptic psychosis MRI volumetric measurements. Patients with epileptic psychosis and normal controls were studied. Left hippocampus values were significantly smaller for patients (P<0.001). Hippocampal ratio was significantly greater for patients (P<0.01). Group (patients x normal) was the only factor explaining the statistically significant variation of left hippocampus and hippocampal ratio (P<0.001 and P<0.05). Twenty patients had hippocampal atrophy (4 on the right side, 15 on the left side, and 1 bilateral) associated with mesial temporal sclerosis. These results confirm the existence of anatomic alterations and a left laterality effect in the mesial temporal lobe structures of patients with epileptic psychosis.
Assuntos
Encéfalo/anormalidades , Encéfalo/patologia , Epilepsia/psicologia , Lateralidade Funcional/fisiologia , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/etiologia , Adulto , Tonsila do Cerebelo/anormalidades , Tonsila do Cerebelo/patologia , Atrofia/epidemiologia , Atrofia/patologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Epilepsia/diagnóstico , Epilepsia/epidemiologia , Feminino , Hipocampo/anormalidades , Hipocampo/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Variações Dependentes do Observador , Transtornos Psicóticos/epidemiologia , Reprodutibilidade dos Testes , Esclerose/epidemiologia , Esclerose/patologia , Índice de Gravidade de Doença , Lobo Temporal/anormalidades , Lobo Temporal/patologiaRESUMO
We investigated a series of patients with epileptic psychosis in Brazil and compared our findings with those of other authors. We evaluated 38 outpatients with epileptic psychosis with a semistructured clinical interview, Annett inventory for hand dominance, international classifications for seizures and syndromes, and DSM-IV for psychosis diagnoses. We studied course and outcome for epilepsy and psychosis. Gender distribution was approximately even. Epilepsy and psychiatric disorders among relatives and early CNS insults in personal histories were frequent findings. Mean age of epilepsy onset was 9.3 years. Epilepsy started before psychosis in all cases, and evolved to clinical refractoriness. There was a predominance of temporal lobe epilepsy. Mean age of psychosis onset was 27.4 years, after a mean duration of epilepsy of 18.1 years, with predominance of schizophrenic presentations with interictal onset, frequent psychiatric admissions, suicide attempts, and postpsychosis functional decline. Tumors or lesions of an embryologic nature were uncommon, but mesial temporal sclerosis was frequent.
