Epilepsies and Psychical Disorders
A. KARVELAS

In the present review we examine:

  1. the psychical manifestations of epileptic seizures in the affect (fear, anxiety, aggresiveness), the experience (memory flashbacks, delirious ideas which can lead to the presentations of various syndromes, such as the syndrome of Capgrass), the sensory organs (visual, auditory, olfactory and gustatory illusions and hallucinations), and consciousness (disorder of its level). We also examine other relative manifestations (compulsive or imposed thoughts, ecstatic experiences, dèjá vu phenomena, tics, neural habits, insomnia or hypersomnolence and unusual behaviors) associated with epilepsy. We study the aggressiveness which manifests itself in epileptic patients during a seizure as welt as acts of violence related to seizures. We offer criteria for assessing the possibility of a patient committing a crime during an episode of epileptic paroxysm and we also make a brief report of syndromes that bear a clear relationship to epilepsy (dreamy state, twilight state, fugue) with an effort to delimit their meaning in the international literature.
  2. the psychical disturbances that may be related to or must be differentially diagnosed from epilepsy (pseudoseizures, dissociative disorders, syndromes of episodic discontrol) and finally.
  3. the relationship between psychoses and epilepsies with an effort to classify them into three categories (posticritical, paracritical and intercritical as well as the relation of psychosis to the onset of epilepsy, its type, the type of epileptic seizures, the seriousness and laterality of EEG findings.