Ictal Cotard delusion as a manifestation of nonconvulsive status epilepticus: A case report and commentary.
Epileptic Disord
; 26(3): 375-381, 2024 Jun.
Article
in En
| MEDLINE
| ID: mdl-38686977
ABSTRACT
Psychosis of epileptic origin can present a wide range of cognitive and affective symptoms and is often underrecognized. Usually occurring in the inter- and postictal phase, epileptic psychosis is mostly related to temporal lobe epilepsy. Here, we describe the clinical presentation and diagnostic workup including routine EEG recording and brain MRI of a 63-year-old woman expressing isolated nihilistic delusions comprising belief of being dead and denial of self-existence. EEG showed an ictal pattern fulfilling the Salzburg criteria of nonconvulsive status epilepticus and brain MRI revealed extensive peri-ictal hyperperfusion. Delusional symptoms and EEG abnormalities subsided after acute antiseizure treatment. Our case illustrates how nihilistic delusions can occur as a direct clinical correlate of seizure activity, thereby expanding the spectrum of ictal neuropsychiatric phenomena in temporal lobe epilepsy and highlighting the need to consider an epileptic origin in patients presenting with psychotic symptoms.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Status Epilepticus
/
Delusions
/
Electroencephalography
Limits:
Female
/
Humans
/
Middle aged
Language:
En
Journal:
Epileptic Disord
Journal subject:
CEREBRO
/
NEUROLOGIA
Year:
2024
Document type:
Article
Affiliation country:
Austria