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Questions and Answers
Patients experiencing automatism always maintain full judgement and awareness during the episode.
Patients experiencing automatism always maintain full judgement and awareness during the episode.
False
Non-convulsive status epilepticus can last for durations shorter than 30 minutes.
Non-convulsive status epilepticus can last for durations shorter than 30 minutes.
True
Approximately 40% of all status epilepticus cases are attributed to non-convulsive status epilepticus.
Approximately 40% of all status epilepticus cases are attributed to non-convulsive status epilepticus.
True
Amnesia is a rare occurrence following episodes of non-convulsive status epilepticus.
Amnesia is a rare occurrence following episodes of non-convulsive status epilepticus.
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Complex partial status and absence status are common types of non-convulsive status epilepticus in older individuals.
Complex partial status and absence status are common types of non-convulsive status epilepticus in older individuals.
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Individuals with automatism often display appropriate behaviors pertinent to their immediate surroundings.
Individuals with automatism often display appropriate behaviors pertinent to their immediate surroundings.
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Behavioral disturbances are a notable symptom of non-convulsive status epilepticus.
Behavioral disturbances are a notable symptom of non-convulsive status epilepticus.
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Clinicians may sometimes misdiagnose non-convulsive status epilepticus as psychiatric disorders due to overlapping symptoms.
Clinicians may sometimes misdiagnose non-convulsive status epilepticus as psychiatric disorders due to overlapping symptoms.
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The classification system proposed by Fenton in 1981 has seen little application in understanding psychiatric disorders in epilepsy.
The classification system proposed by Fenton in 1981 has seen little application in understanding psychiatric disorders in epilepsy.
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Psychiatric presentations in epilepsy can only result from seizures and have no correlation with any pre-existing mental health conditions.
Psychiatric presentations in epilepsy can only result from seizures and have no correlation with any pre-existing mental health conditions.
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Most peri-ictal presentations are specific to epilepsy and include symptoms such as postictal psychosis.
Most peri-ictal presentations are specific to epilepsy and include symptoms such as postictal psychosis.
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The term 'organic' is used to refer to psychiatric conditions that have no connection to epilepsy.
The term 'organic' is used to refer to psychiatric conditions that have no connection to epilepsy.
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Interictal psychiatric disorders in epilepsy conform to standard diagnostic criteria for conditions like schizophrenia and might not have an epilepsy-specific cause.
Interictal psychiatric disorders in epilepsy conform to standard diagnostic criteria for conditions like schizophrenia and might not have an epilepsy-specific cause.
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Focal motor seizures are not a common manifestation of simple partial status.
Focal motor seizures are not a common manifestation of simple partial status.
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Auras associated with simple partial status can last for several hours, days, or even years.
Auras associated with simple partial status can last for several hours, days, or even years.
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Absence status is characterized by a continuous 5-Hz spike-and-wave EEG pattern.
Absence status is characterized by a continuous 5-Hz spike-and-wave EEG pattern.
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Episodes of absence status usually occur shortly after a patient's initial epilepsy diagnosis.
Episodes of absence status usually occur shortly after a patient's initial epilepsy diagnosis.
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Distinguishing simple partial status from psychiatric disorders is straightforward and does not pose challenges.
Distinguishing simple partial status from psychiatric disorders is straightforward and does not pose challenges.
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EEG analysis is unimportant in diagnosing simple partial status and absence status.
EEG analysis is unimportant in diagnosing simple partial status and absence status.
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Recurrent episodes of absence status occur in over 90% of patients.
Recurrent episodes of absence status occur in over 90% of patients.
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Simple partial status can manifest with symptoms that overlap with those of psychiatric disorders.
Simple partial status can manifest with symptoms that overlap with those of psychiatric disorders.
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The estimated point prevalence of DSM major depression in epilepsy patients ranges from 3% to 22% over a year.
The estimated point prevalence of DSM major depression in epilepsy patients ranges from 3% to 22% over a year.
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Bipolar disorder is significantly over-represented in epilepsy, with prevalence rates exceeding 10%.
Bipolar disorder is significantly over-represented in epilepsy, with prevalence rates exceeding 10%.
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Depression in epilepsy may present with atypical symptoms that do not meet standard diagnostic criteria.
Depression in epilepsy may present with atypical symptoms that do not meet standard diagnostic criteria.
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A direct relationship between seizure frequency and depression is consistently found across all studies.
A direct relationship between seizure frequency and depression is consistently found across all studies.
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Around half of the patients with epilepsy were reported to have been seizure-free for over a year.
Around half of the patients with epilepsy were reported to have been seizure-free for over a year.
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The term 'interictal dysphoric disorder' refers to typical presentations of depression in epilepsy.
The term 'interictal dysphoric disorder' refers to typical presentations of depression in epilepsy.
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Depression is seldom considered common in patients with temporal lobe epilepsy.
Depression is seldom considered common in patients with temporal lobe epilepsy.
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Research has validated the distinctiveness of atypical presentations of depression in epilepsy.
Research has validated the distinctiveness of atypical presentations of depression in epilepsy.
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Postictal psychosis does not typically require any form of medication.
Postictal psychosis does not typically require any form of medication.
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Chronic interictal psychosis can arise as a long-term consequence of recurrent postictal psychosis.
Chronic interictal psychosis can arise as a long-term consequence of recurrent postictal psychosis.
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The pathophysiology of postictal psychosis is completely understood and distinct from all other psychotic conditions.
The pathophysiology of postictal psychosis is completely understood and distinct from all other psychotic conditions.
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Temporal lobe epilepsy (TLE) has no significant correlation with the occurrence of postictal psychosis.
Temporal lobe epilepsy (TLE) has no significant correlation with the occurrence of postictal psychosis.
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Family history of affective disorders is consistently linked to postictal psychosis as a risk factor.
Family history of affective disorders is consistently linked to postictal psychosis as a risk factor.
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Benzodiazepine sedation is frequently used as the first line of treatment for postictal psychosis.
Benzodiazepine sedation is frequently used as the first line of treatment for postictal psychosis.
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Postictal psychosis is characterized by a gradual onset of symptoms following seizures.
Postictal psychosis is characterized by a gradual onset of symptoms following seizures.
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The prevalence of depression in epilepsy can vary between 4% and 37% depending on the population studied.
The prevalence of depression in epilepsy can vary between 4% and 37% depending on the population studied.
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Frequent seizure clustering is a risk factor for developing postictal psychosis.
Frequent seizure clustering is a risk factor for developing postictal psychosis.
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Interictal disorders such as anxiety rarely occur in individuals with epilepsy.
Interictal disorders such as anxiety rarely occur in individuals with epilepsy.
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West syndrome and Lennox-Gastaut syndrome are examples of cognitive manifestations attributable to epilepsy.
West syndrome and Lennox-Gastaut syndrome are examples of cognitive manifestations attributable to epilepsy.
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Prodromal symptoms are reported to occur in 5-15% of epilepsy patients.
Prodromal symptoms are reported to occur in 5-15% of epilepsy patients.
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Ictal psychiatric disorders can include manifestations like delirium and psychosis during a seizure.
Ictal psychiatric disorders can include manifestations like delirium and psychosis during a seizure.
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The term 'prodrome' describes symptoms that are part of the seizure.
The term 'prodrome' describes symptoms that are part of the seizure.
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Interictal psychiatric disorders can include conditions like schizophrenia-like psychosis.
Interictal psychiatric disorders can include conditions like schizophrenia-like psychosis.
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Dissociative seizures are classified as pre-ictal disorders.
Dissociative seizures are classified as pre-ictal disorders.
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Automatisms refer to reflexive actions that occur during the pre-ictal phase of a seizure.
Automatisms refer to reflexive actions that occur during the pre-ictal phase of a seizure.
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Postictal psychosis is characterized by symptoms that usually last for an average of 7 days.
Postictal psychosis is characterized by symptoms that usually last for an average of 7 days.
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The neurobehavioral manifestations in patients with epilepsy are considered primarily consequences of the underlying brain disorder rather than the epilepsy itself.
The neurobehavioral manifestations in patients with epilepsy are considered primarily consequences of the underlying brain disorder rather than the epilepsy itself.
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EEG findings during postictal episodes may show diffuse slowing in conjunction with interictal epileptiform abnormalities.
EEG findings during postictal episodes may show diffuse slowing in conjunction with interictal epileptiform abnormalities.
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Epileptic auras can be solely mental phenomena and may not include physical manifestations.
Epileptic auras can be solely mental phenomena and may not include physical manifestations.
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Epilepsy with continuous spike-and-wave during slow-wave sleep is a known general epileptic syndrome.
Epilepsy with continuous spike-and-wave during slow-wave sleep is a known general epileptic syndrome.
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The abrupt onset of symptoms is a key characteristic of delirium following seizures.
The abrupt onset of symptoms is a key characteristic of delirium following seizures.
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A history of epilepsy is a common trigger for postictal psychosis manifestations.
A history of epilepsy is a common trigger for postictal psychosis manifestations.
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Full recovery of consciousness after a generalized tonic-clonic seizure is typically quicker than after a temporal lobe seizure.
Full recovery of consciousness after a generalized tonic-clonic seizure is typically quicker than after a temporal lobe seizure.
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Delusions seen in postictal psychosis can manifest in forms such as paranoid, grandiose, and religious themes.
Delusions seen in postictal psychosis can manifest in forms such as paranoid, grandiose, and religious themes.
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Impaired consciousness is essential for diagnosing non-convulsive status.
Impaired consciousness is essential for diagnosing non-convulsive status.
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Patients may experience alertness and responsiveness shortly after a seizure, followed by symptoms like headache and drowsiness.
Patients may experience alertness and responsiveness shortly after a seizure, followed by symptoms like headache and drowsiness.
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People with epilepsy experience a lower risk of suicide compared to the general population.
People with epilepsy experience a lower risk of suicide compared to the general population.
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Interictal schizophrenia-like psychoses can occur in individuals with epilepsy and meet schizophrenia diagnostic criteria.
Interictal schizophrenia-like psychoses can occur in individuals with epilepsy and meet schizophrenia diagnostic criteria.
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Seizure phobia is when the fear of seizures is less disabling than the seizures themselves.
Seizure phobia is when the fear of seizures is less disabling than the seizures themselves.
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A recent cohort study found a standardized mortality ratio for suicide at 5.0 in patients with epilepsy.
A recent cohort study found a standardized mortality ratio for suicide at 5.0 in patients with epilepsy.
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Studies have universally found an increased prevalence of schizophrenia-like psychosis in epilepsy patients compared to those with migraines.
Studies have universally found an increased prevalence of schizophrenia-like psychosis in epilepsy patients compared to those with migraines.
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The mean seizure frequency in generalized epilepsy is six per month.
The mean seizure frequency in generalized epilepsy is six per month.
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A study showed that 55% of patients with chronic epilepsy had idiopathic generalized epilepsy.
A study showed that 55% of patients with chronic epilepsy had idiopathic generalized epilepsy.
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Temporal lobectomy is associated with an increase in psychiatric morbidity when seizures are eliminated.
Temporal lobectomy is associated with an increase in psychiatric morbidity when seizures are eliminated.
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Patients with a history of depression are at a lower risk of experiencing depression following temporal lobectomy.
Patients with a history of depression are at a lower risk of experiencing depression following temporal lobectomy.
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The relationship between demographic factors and epilepsy-related depression has shown consistent patterns across studies.
The relationship between demographic factors and epilepsy-related depression has shown consistent patterns across studies.
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Research indicates that one quarter of patients with adult-onset idiopathic generalized epilepsy have a history of depression.
Research indicates that one quarter of patients with adult-onset idiopathic generalized epilepsy have a history of depression.
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Anxiety rates are reported to be lower than depression rates among individuals with epilepsy.
Anxiety rates are reported to be lower than depression rates among individuals with epilepsy.
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Adverse psychiatric reactions are recognized side effects of some antiepileptic drugs.
Adverse psychiatric reactions are recognized side effects of some antiepileptic drugs.
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The duration of post-surgery depression episodes is typically longer than six months.
The duration of post-surgery depression episodes is typically longer than six months.
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The stigma surrounding epilepsy does not significantly impact the lives of those affected.
The stigma surrounding epilepsy does not significantly impact the lives of those affected.
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Automatisms are a form of behavior linked solely to postictal delirium.
Automatisms are a form of behavior linked solely to postictal delirium.
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The term 'hypokinetic' refers to an increase in the rate of ongoing movements.
The term 'hypokinetic' refers to an increase in the rate of ongoing movements.
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Lip-smacking and swallowing movements are classified under oro-alimentary automatisms.
Lip-smacking and swallowing movements are classified under oro-alimentary automatisms.
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The subject experiences complete awareness of their actions during automatisms.
The subject experiences complete awareness of their actions during automatisms.
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Automatisms can include complex movements influenced by environmental factors.
Automatisms can include complex movements influenced by environmental factors.
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Thirty percent of automatisms last longer than fifteen minutes.
Thirty percent of automatisms last longer than fifteen minutes.
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Gestural automatisms typically involve the use of both hands.
Gestural automatisms typically involve the use of both hands.
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Verbal automatisms can include repetitive sounds like grunts.
Verbal automatisms can include repetitive sounds like grunts.
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Automatisms are often longer than five minutes in duration.
Automatisms are often longer than five minutes in duration.
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Interactional automatisms are always environmentally influenced.
Interactional automatisms are always environmentally influenced.
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The term 'dyscrastic' pertains to uncontrolled crying.
The term 'dyscrastic' pertains to uncontrolled crying.
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Hyperkinetic movements are primarily generated by proximal limb and axial muscles.
Hyperkinetic movements are primarily generated by proximal limb and axial muscles.
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The term 'glastic' implies a complete dysfunction of language-related pathways.
The term 'glastic' implies a complete dysfunction of language-related pathways.
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Automatisms may sometimes appear clumsy and repetitive in nature.
Automatisms may sometimes appear clumsy and repetitive in nature.
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Study Notes
Classification of Psychiatric Symptoms and Syndromes in Epilepsy
- Fenton (1981) developed a system for classifying psychiatric disorders in epilepsy, finding widespread use (Table 6.9)
- Psychiatric presentations in epilepsy may be attributed to the underlying cause of seizures.
- If not a clear relationship, there might be a temporal relationship between episodic psychiatric symptoms and seizures.
- Certain psychiatric presentations may precede or arise as a direct manifestation of an epileptic discharge.
- Some patients develop persistent or recurrent psychiatric disorders unrelated to seizure activity.
- Most peri-ictal presentations are unique to epilepsy (e.g., prodromal symptoms, epileptic auras, and post-ictal psychosis).
- Interictal disorders include standard psychiatric conditions like depression or schizophrenia.
- The term "organic" might be used to recognise a presumed causal association with epilepsy (e.g., organic depressive disorder, organic psychosis).
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Description
Test your knowledge on non-convulsive status epilepticus and its symptoms, including automatism and behavioral disturbances. This quiz will challenge your understanding of this condition and its psychiatric presentations, as well as the history of classification systems related to epilepsy.
