Relationships between pre‐, post‐, and inter‐ictal psychiatric symptoms in patients with epilepsy
Shingo Yasumoto, Hiromichi Motooka, Yuji Ito, Masaya Mashimoto, Kenta Murotani, Ryota Ogata, Motohiro OzoneAbstract
Aim
Although pre‐ and post‐ictal psychiatric symptoms (PS) in patients with epilepsy are well known, the prevalences and pathophysiologies remain unclear. We investigated the prevalences and durations of pre‐ and post‐ictal PS, related factors, and associations between pre‐ and post‐ictal PS.
Methods
In the Neuropsychiatry Department of Kurume University Hospital, patients with epilepsy were interviewed regarding pre‐ and post‐ictal PS. Multivariate logistic regression analyses were performed on clinical variables and pre‐ or post‐ictal PS. McNemar analyses were performed to clarify differences in the occurrence of pre‐ and post‐ictal PS.
Results
Five percent of patients had only pre‐ictal PS, 29% had only post‐ictal PS, and 10% had both pre‐ and post‐ictal PS. The most common symptoms were depressive symptoms (25%) and anxiety symptoms (16%) in the post‐ictal period, and irritability symptoms (7%) and anxiety symptoms (5%) in the pre‐ictal period. The duration of PS was more than 1 day but less than 1 week in many patients. Post‐ictal PS showed a substantially higher ratio of a history or comorbidities of inter‐ictal psychiatric disorders (IPD). In addition, post‐ictal psychotic symptoms and post‐ictal irritability symptoms were significantly associated with psychosis in IPD. Furthermore, while the incidence of PS was significantly higher with post‐ictal PS alone than with pre‐ictal PS, cases with pre‐ictal PS had a significantly higher rate of post‐ictal PS.
Conclusion
Post‐ictal PS appeared relevant to IPD, and pre‐ictal PS was associated with the expression of post‐ictal PS.