Acute psychosis during intracranial EEG monitoring: Close relationship between psychotic symptoms and discharges in amygdala

Purpose: This report examined the underlying mechanism of psychosis associa ted with epilepsy. Methods: An adult patient with epilepsy manifesting acute psychosis during long-term EEG monitoring is presented, together with a literature review on this subject. Results: A 25-year-old woman with intractable temporal lobe epilepsy develo ped acute psychosis while she underwent long-term intracranial EEG monitori ng. After a clustering of seizures, she manifested psychotic symptoms inclu ding hallucination, stupor, and repeated fear. The transition of psychotic symptoms corresponded to the changes in frequency and morphology of seizure discharges restricted to the left amygdala. Improvement of psychosis coinc ided with disappearance of seizure discharges. Conclusions: This case confirmed a close relationship between psychotic sym ptoms and seizure discharges in the left amygdala. It is suggested that par oxysmal bombardment of the medial temporal lobe structure may be a pathogen etic factor of acute psychosis associated with epilepsy.