発作後精神病状態 - 発作間歇期急性・慢性精神病状態との比較

京都大学0048新制・論文博士博士(医学)乙第9522号論医博第1607号新制||医||669(附属図書館)16257UT51-97-H359(主査)教授 柴﨑 浩, 教授 木村 淳, 教授 三好 功峰学位規則第4条第2項該当Doctor of Medical ScienceKyoto UniversityDA

Behavioural disorder in people with an intellectual disability and epilepsy: a report of the Intellectual Disability Task Force of the Neuropsychiatric Commission of ILAE

The management and needs of people with intellectual disability (ID) and epilepsy are well evidenced; less so, the comorbidity of behavioural disorder in this population. ‘Behavioural disorder’ is defined as behaviours that are difficult or disruptive, including stereotypes, difficult or disruptive behaviour, aggressive behaviour toward other people, behaviours that lead to injury to self or others, and destruction of property. These have an important link to emotional disturbance. This report, produced by the Intellectual Disability Task Force of the Neuropsychiatric Commission of the ILAE, aims to provide a brief review of some key areas of concern regarding behavioural disorder among this population, and proposes a range of research and clinical practice recommendations generated by Task Force members. The areas covered in this report were identified by experts in the field as being of specific relevance to the broad epilepsy community when considering behavioural disorder in persons with epilepsy and ID; they are not intended to be exhaustive. The practice recommendations are based on the authors’ review of the limited research in this field combined with their experience supporting this population. These points are not graded but can be seen as expert opinion guiding future research and clinical practice

Psychotic illness in patients with epilepsy

Apart from the rather rare ictal psychotic events, such as non-convulsive status epilepticus, modern epileptic psychoses have been categorized into three main types; chronic and acute interictal psychoses (IIPs) and postictal psychosis (PIP). Together, they comprise 95% of psychoses in patients with epilepsy (PWE). Four major questions, that is, “Is psychosis in PWE a direct consequence of epilepsy or schizophrenia induced by epilepsy?”, “Is psychosis in PWE homogeneous or heterogeneous?”, “Does psychosis in PWE have symptomatological differences from schizophrenia and related disorders?”, “Is psychosis in PWE uniquely associated with temporal lobe epilepsy (TLE)?” are tried to be answered in this review with relevant case presentations. In the final section, we propose a tentative classification of psychotic illness in PWE, with special attention to those who have undergone epilepsy surgery. Psychotic disorders in PWE are often overlooked, mistreated, and consequently lingering on needlessly. While early diagnosis is unanimously supported as a first step to avoid this delay, necessity of switching from antiepileptic drugs with supposedly adverse psychotopic effects. to others is more controversial. To elucidate the riddle of alternative psychosis, we need badly further reliable data

Graphogenic epilepsy: a variant of language-induced epilepsy distinguished from reading- and praxis-induced epilepsy

AbstractWe report a case of graphogenic epilepsy as a variant of language-induced epilepsy. A 25-year-old, right-handed woman had noticed for the previous 10 years that writing almost always provoked jerks or a jerking sensation in her right hand. No other triggers, including facets of language function such as reading and speaking, elicited any epileptic seizures. Ictal EEG demonstrated an initial left central abnormality. In our report, we stress that graphogenic seizures as an expression of language-induced epilepsy should not be confused with those that are manifestations of juvenile myoclonic epilepsy, and that writing and reading trigger different facets of motor manifestations