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Neuropsychiatric Disorders > Psychiatric Manifestations Of Epilepsy > Flashcards

Psychiatric Manifestations Of Epilepsy Flashcards

1
Q

What is proportion of people with epilepsy have a lifetime history of psychiatric disorder?

A

1 in 3

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2
Q

What are the most common psychiatric disorders found in PWE?

A

Depression
Mood disorders
Psychiatric disorders
Personality disorders

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3
Q

What is the prevalence of ADHD comorbidity with epilepsy? (Wang et al 2023)

A

ADHD in epilepsy 22.3%
Epilepsy in ADHD 3.4%

(Epilepsy in general population is 0.5-1%)

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4
Q

What were the rates of suicide-related experiences in Wang et al 2023?

A

Suicidal ideation 19.3% (OR 2.7)
Suicide attempts 5.96% (OR 2.74)
Completed suicide 0.24% (OR 2.36)

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5
Q

What is the rate of major depression in people with epilepsy?

A

17.4% (10.7% in general population)

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6
Q

What is the rate of mood disorder in people with epilepsy?

A

34.2% (19.6% in general population)

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7
Q

What psychiatric conditions are predisposing factors for epilepsy?

A

ADHD
Depression
Suicidality
Psychosis
Schizophrenia

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8
Q

What are the overlapping risks of epilepsy and schizophrenia?

A

Risk of developing schizophrenia in epilepsy - 7x
Risks of developing epilepsy in primary schizophrenia - 6x

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9
Q

What are the most frequently diagnosed disorders in adults with epilepsy?

A

Mental retardation
Bipolar disorder
Alcohol or drug psychosis

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10
Q

What positive effects might ASMs have on neuropsychiatric disorders?

A

Mood stabilising (valproate, carbamazepine, lamotrigine)
Antidepressant (lamotrigine)
Anxiolytic (pregabalin, gabapentin)

Withdrawal may lead to reemergence of symptoms

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11
Q

What are associated with increased risk of psychiatric disorders in epilepsy?

A

Generalised seizures
High seizure frequency
High number of A&E/outoatient visits
Hospitalisation
Older age

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12
Q

What ASMs might cause adverse psychiatric effects?

A

Barbiturates
Topiramate
Levetiracetam
Benzodiazepines
Vigabatrin
Zonisamide

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13
Q

What kind of surgery is most associated with worsening anxiety and depression in PWE?

A

Temporal lobe resection

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14
Q

How does depression affect post-surgery prognosis?

A

Reduces chance of becoming seizure free in two years after surgery

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15
Q

What is the NDDI-E used for?

A

To screen for depression in people with epilepsy

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16
Q

Which sub groups of PWE are more susceptible to depression?

A

Temporal lobe epilepsy
Drug refractory epilepsy
Neurological comorbidity
Female patients

17
Q

Which ASMs are associated with depression?

A

Levetiracetam (Keppra)

18
Q

What are the implications of using TCAs in PWE?

A

May have a pro convulsant effect
High plasma levels are associated with increased seizure risk but not at therapeutic levels or below

19
Q

What particular antidepressant is associated with increased seizure risk?

A

Clomipramine

20
Q

What non drug avenues may be used for depression in epilepsy

A

Psychotherapy
Online self treatment

21
Q

How do sertraline and CBT compare for MDD in epilepsy?

A

After 16 weeks
53% reduction with sertraline
60% reduction with CBT

22
Q

What are ILAE clinical guidelines for depression in epilepsy?

A

Supportive psychotherapy for new diagnoses
SSRIs as first line
Expedite treatment for sll

23
Q

What effect may SSRIs have on seizures

A

Protective possibly
535 vs 1502 per 100k in placebo

24
Q

How long after recovery from depression should antidepressants be used?

A

6 months after first episode
2 years after subsequent episodes

25
Q

What are the pharmacological interactions between antidepressants and ASMs?

A

Fluoxetine and fluvoxamine can increase serum ASM

26
Q

What feature of autoimmune encephalitis may be mistaken as epilepsy?

A

Seizures or dyskinesia that is misdiagnosed as seizures

27
Q

What radiological features are associated with juvenile myoclonic epilepsy?

A

Prefrontal abnormalities

28
Q

What is the rate of psychiatric disorders in children with epilepsy?

A

37% (56% in complicated epilepsy)

29
Q

What is a common misdiagnosis of autism in people with epilepsy?

A

Personality disorder

Neuropsychiatric Disorders (15 decks)

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