瘤疾患者에서 보이는 精神病에 關한 臨床的 考察

A Clinical Study on Psychosis in Epileptic Patients

The relationship between psychosis and epilepsy has been discussed since antiquity. But the question of psychosis among epileptic patients with respect to the incidence, the relationship between psychosis and the type of epilepsy, and the lateralization of the epileptogenic focus is still controversial. The authors conducted this clinical investigation to clarify these various controversial relationships, and to contribute to the prevention and treatment of psychosis in epilepsy. For this retrospective study, the 962 epileptic patients who had been treated in the Yong-In Mental Hospital over a 5-year period extending from November 1981 to April 1986 were analyzed. The results were as follows: 1) Among the 962 epileptic patients, 38 patients (4.0%) manifested psychotic symptoms. 2) Concerning the time interval between the onset of epilepsy and the onset of psychosis in these 38 patients, it was found to be an average duration of 11 years and 8 months (ranging from a minimum of 2 years to maximum of 23 years). The older an individual was when he became an epileptic patient, the longer the period of time passed for the psychosis to develop. 3) Regarding the relationship between the type of epilepsy and the type of psychosis, those patients that manifested a paranoid-hallucinatory state commonly experienced primary generalized seizure. 4) The difference between paranoid-hallucinatory state patients with respect to left-sided focality of the EEG was statistically significant, i.e., schizophrenia-like stae patients showed less EEG laterality to the left. 5) The difference between p aran oid-hallu cin atory state patients and schizophrenia-like state patients with respect to responsiveness to neuro leptics was statistically significant, i.e., neuroleptics had significantly less effect on patients in the schizophrenia-like stae than on patients in the paranoid-hallucinatory state. The effects of neuroleptics were not correlated with the age of the patient. Finally，ideally further research in this particular area should rely on prospective longitudinal studies of young, non-psychotic epileptics