Epileptic psychiatric disorders manifest in various forms and are broadly classified as seizure and persistent. The former can occur before, during, or after a seizure, and can be part of a seizure or a separate seizure. The former can occur before, during, or after a seizure, and can be part of a seizure or a separate seizure. Seizures are sudden, transient, and recurrent in nature. Persistent psychiatric disorders, mainly chronic schizophrenic-like disorder, personality changes, and intellectual impairment, may develop years after the seizures. It is reported that 25 or 27% of epileptic patients have significant psychiatric disorders.
A partial seizure is a seizure that starts on one side of the brain (focal or limited) and can extend to both sides. If the seizure is not accompanied by impaired consciousness, it is called a simple partial seizure. If the seizure is accompanied by impaired consciousness and cannot be recalled after the seizure, it is called a complex partial seizure.
Second, generalized seizures, the common ones are.
1, generalized tonic clonic seizures (grand mal): characterized by generalized convulsions and impaired consciousness. Followed by tonic phase, clonic phase, late convulsion. From the beginning of the seizure to the recovery of consciousness is about 5-10 minutes. After waking up, the patient feels headache, fatigue and has no recollection of the convulsions. Some patients go into a coma after the seizure, and some have autonomic symptoms and blurred consciousness before they are fully awake. If a grand mal seizure occurs frequently within a short period of time so that the consciousness continues to be comatose during the interval between seizures, it is called status epilepticus.
2.Absence seizure (petit mal): brief loss of consciousness, no response to call, both eyes staring, lasting 3-15 seconds, no aura or local symptoms. Both seizure and cessation are sudden. There is no memory of the seizure.
3. Myoclonic seizures: sudden, rapid, brief muscle contractions involving the whole body or limited to the face, trunk and extremities.
Third, episodic mental disorder this type of mental disorder can be accompanied by grand mal seizures or other types of seizures, or there may be only psychotic seizures, that is, the sudden appearance of mental disorder as a seizure.
1, psychomotor seizures, seizures rarely have impairment of consciousness, but there are subjective abnormal experiences.
1) Perceptual disturbances, mostly primitive hallucinations, such as fire, lightning, unpleasant strange smell, or illusions, perceptual syndrome (such as time perception syndrome, déjà vu syndrome and old as new syndrome), and body image disturbances.
2) Thought disorders, which may include interrupted thinking and obsessive-compulsive thinking.
3) Affective disorders, mostly fear, depression, or anxiety and other poor state of mind. Sometimes there may be sudden rage and aggressive behavior.
4) Plant nerve dysfunction, often with abdominal pain, nausea and vomiting, palpitations, shortness of breath or pause, sweating, salivation, pale or flushed face, etc.
5) Autonomic-like manifestations may occur.
Psychomotor episodes last for a short time, often several minutes, occasionally up to several hours.
2. Automatism: It is one of the most common manifestations of temporal lobe epilepsy and is mostly accompanied by other forms of seizures such as grand mal seizures, and rarely by seizures alone.
1) Most patients have aura, such as abnormal somatic sensation, delusion, hallucination, perceptual syndrome, and disorganized thinking.
2) The seizure starts suddenly with blurred consciousness and incomprehensible movements such as tongue sticking, chewing, swallowing, lip smacking, walking, running, making faces, undressing and dressing, unbuttoning, tying, moving objects, tearing things and other repetitive or stereotyped movements. Some episodes may continue with the original work, or continue to walk or ride a bicycle, etc. The patient’s face is pale and dull, but it is not easy to be noticed by the surrounding people. They can occur several times a day for a few minutes each time and cannot be recalled after waking up.
3, epileptic haze of consciousness: mainly for reduced clarity of consciousness and narrow range of consciousness, the clinical manifestations are more complex, with sudden seizures, disorientation, poor perception of surrounding things, accompanied by kinetic hallucinations, hallucinations, fragmentary delusions, fear, anger, behavioral disorders, with injury, destruction, impulsive and other aggressive behavior. Some of them may appear to be similar to schizophrenia.
4.Pathological bad mood: usually in a clear state of consciousness, sudden attacks can last for several hours to days. The performance of no apparent reason for the mood depression, distress, discomfort, fear, tension. Feel dissatisfied with the surrounding, critical, sometimes angry, aggressive behavior, cruel nature. After a seizure, the person becomes aware of the change in his or her mood and tries to get rid of it. Seizures may occur in order to relieve pain by continuous drinking (intermittent alcoholic binge) or wandering aimlessly (epileptic wandering).
5, epileptic acute schizophrenic-like psychosis, with nervousness, uncooperative, increased movement, noisy and restless psychomotor excitement, and hallucinations, delusions as the most common, but also performance of emotional indifference, reticence, slow movement, clear consciousness.
Fourth, persistent mental disorder 1, epileptic chronic psychosis.
1) Chronic paranoid states, such as delusions of relationship and delusions of victimization, are mostly seen clinically.
2)There may be schizophrenia-like thought disorder, such as word new work, compulsive thinking, thought interruption, thought being taken away, etc.
3) Perceptual disorders are mostly seen as hallucinations, the content of which can be persecutory command, etc.
4) Affective disorders are mostly irritable, depressed, fearful, anxious, occasionally euphoric, and some patients show emotional indifference.
5) The condition can last for months to years, without the tendency of spontaneous remission.
2. Epileptic personality can have changes such as sticky tape, irritability, warmth and instability. The same patient can have either one tendency to predominate or both polar characteristics, such as overly clingy, irritable, and gentle.
3.Epileptic dementia.
4.Other: such as sexual dysfunction due to epilepsy, amnesia syndrome, neurotic syndrome, etc.