COMPARISON OF PSYCHOTIC STATES IN PATIENTS WITH IDIOPATHIC GENERALIZED EPILEPSY AND TEMPORAL-LOBE EPILEPSY

We compared the characteristics of psychotic symptoms and pathogeneses of psychotic states in patients with idiopathic generalized epilepsy (IGE) and temporal lobe epi lepsy (TLE). Sixty-seven patients with IGE and 105 patients with TLE who were treated in our psychiatric clinic between December 1991 and July 1996 were selected. The clinical charac teristics of the psychotic states accompanying each type of epilepsy w ere investigated retrospectively. Psychotic states were ascertained in 19.4% of the patients with IGE and 15.2% of the patients with TLE. Th e psychotic states of the patients with TLE tended to be more chronic than those of the patients with IGE. The characteristic psychotic symp toms were perplexed behavior and other various psychotic symptoms in t he IGE group and hallucinations, delusions, and bad temper in the TLE group. The correlation with seizures was more evident in the TLE group than in the IGE group, because the seizure frequencies before the ons et of psychotic states were significantly higher in the TLE group. The relationship between epileptic discharges and psychotic state was sig nificantly more distinct in the IGE group. However, 3 patients with TL E with episodic psychotic states were mentally improved after temproal lobectomy, which suggested that deep midtemporal epileptic discharges might have been the cause of their psychotic states. The psychotic sy mptoms of the patients with IGE and those with TLE were clearly differ ent, and the incessant epileptic discharges of the different cerebral regions might be a key factor in the psychotic states accompanying bot h types of epilepsy.