Episodic Psychotic States in Temporal Lobe Epilepsy: An Investigation on Their Physiopathogenesis

Abstract. The discussion here is about the direct relationship of epileptic seizures to episodic psychotic states. The episodic psychotic states were divided into three groups: interictal, ictal and postictal. In each group, one representative case was described and the neurophysiological pathogenesis discussed according to a recent research, mainly depth-electrode findings. It is believed that: 1) interictal psychotic state—limbic paroxysmal discharges play an important role in its pathogenesis, according to the theory of Geschwindt and others; 2) ictal psychotic state—repetitive auras develop to the psychotic state, and aura continua itself can be described as a psychotic state; and 3) postictal psychotic state—the increased limbic discharges might be responsible for the psychotic state. The common neurophysiological cause in all the three groups is due to the increased epileptic discharges in the limbic system. It is concluded that the episodic psychotic states in temporal lobe epilepsies are possibly of an epileptic nature in themselves.