To test the hypothesis that some particular magnetoencephalographic findings characterize psychosis manifesting in temporal lobe epilepsy (TLE) patients, the authors performed statistical analyses on the correlation between a history of psychosis and four magnetoencephalographic spike-dipole patterns, namely, left and right inferotemporal-horizontal (IH) and superotemporal-vertical (SV) types. Fifty-seven patients with TLE were studied, 16 of whom had a history of psychosis. Of the four types of spike-dipoles, only left SV type showed a strong correlation with psychosis, suggesting that dysfunction of the left temporal neocortex specifically contributes to the manifestation of psychotic symptoms in TLE patients.
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"In this connection, although verbal auditory hallucination was frequently found in patients with a history of psychosis among our subjects, psychotic hallucination was carefully excluded from auditory and psychic seizures. The problem of psychosis in these patients was treated in detail elsewhere (Fukao et al., 2009). ''No aura'' may also be considered a type of aura. "
[Show abstract][Hide abstract] ABSTRACT: To estimate magnetoencephalography (MEG) correlates of different types of aura in temporal lobe epilepsy (TLE).
MEG study was performed on 57 patients (26 male and 31 female) with TLE, whose ages ranged from 14-46 years (mean 27 years). Interictal magnetoencephalograms showing discharges were analyzed, and spike-dipole clusters were categorized into left and right inferotemporal-horizontal (IH) and superotemporal-vertical (SV) types. Auras were classified into autonomic, auditory, and psychic seizures. The correlation between the four types of interictal spike-dipole and three types of aura was analyzed using Fisher's exact probability test.
IH type correlated with autonomic seizures (p = 0.0004), whereas SV type correlated with both auditory (p = 0.0002) and psychic seizures (p = 0.042). When subdivided into left and right, left IH type correlated with autonomic seizures (p = 0.046), but right IH type did not. Right SV type correlated with both auditory (p = 0.014) and psychic seizures (p = 0.002), but left SV did not correlate with either. Both types did not correlate with "no aura."
Using our proposed classification of spike-dipoles, MEG distinguishes auras of mesial temporal origin from those of lateral temporal region. Furthermore, by adopting our classification, laterality of spike-dipoles is clearly demonstrated in auditory and psychic seizures.
[Show abstract][Hide abstract] ABSTRACT: The authors critically reviewed all relevant peer-reviewed quantitative research pertaining to the risk factors for psychosis secondary to temporal lobe epilepsy, carrying out an extensive literature search to identify all relevant research studies, and applying specific exclusion criteria; the search yielded 27 original research articles for critical review. These studies were individually assessed for methodological quality. Authors reached consensus on a number of important risk factors for psychosis, including early age at epilepsy onset, history of status epilepticus, hippocampal sclerosis, and left-hemisphere abnormalities. Inconsistencies in defining and diagnosing epileptic psychoses were apparent, as well as the sole use of case-control, cross-sectional, and/or retrospective study designs. There remains a need for research using consistent classification criteria and longitudinal study designs.
The Journal of Neuropsychiatry and Clinical Neurosciences 02/2014; 26(1):5-23. DOI:10.1176/appi.neuropsych.12120403 · 2.82 Impact Factor
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