Email updates

Keep up to date with the latest news and content from Journal of Medical Case Reports and BioMed Central.

Open Access Highly Accessed Case report

A patient with medication-resistant epilepsy featuring psychosensorial and psychotic symptoms presenting with significant functional improvement on psychotherapeutic treatment: a case report

Luigi De Benedictis1*, Alexandre Dumais2, Luc Nicole3, Christine Grou4 and Alain D Lesage567

Author Affiliations

1 Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Université de Montréal, 7401, Rue Hochelaga, Montréal, Québec H1N 3M5, Canada

2 Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Institut Philippe-Pinel de Montréal, Université de Montréal, Montreal, Québec, Canada

3 Department of Psychiatry, Institut Universitaire en Santé Mentale de Montréal, Université de Montréal, Montreal, Québec, Canada

4 Department of Psychology, Institut Universitaire en Santé Mentale de Montréal, Université de Montréal, Montreal, Québec, Canada

5 Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montreal, Québec, Canada

6 Department of Psychiatry, Université de Montréal, Montreal, Québec, Canada

7 Institut Universitaire en Santé Mentale de Montréal, Montreal, Québec, Canada

For all author emails, please log on.

Journal of Medical Case Reports 2013, 7:259  doi:10.1186/1752-1947-7-259

Published: 11 November 2013

Abstract

Background

Partial complex epilepsy with psychosensorial and psychotic symptoms remains a relatively rare condition that can sometimes be mistaken for an axis I psychiatric disorder. There is no specific treatment for this particular type of epilepsy, anti-epileptic medication being the cornerstone of therapeutic intervention with the occasional addition of neuroleptics. Lack of response to anti-epileptic agents is often a sign of poor prognosis and requires risky and sometimes invasive interventions with high morbidity for patients.

Case presentation

We report the case of a 21-year-old right-handed Caucasian man of French-Canadian descent who was living with his mother immediately before being hospitalized in a psychiatric setting for the first time. He seemed obsessed with developing new concepts to reach a more ‘perfect’ existence. He also claimed feeling odd sensations in his mind and in his body that could be linked to some sort of ‘evolutionary’ process resulting from spiritual uplift. He reported non-specific visual hallucinations and what sounded like auditory hallucinations and telepathic powers. The first diagnosis was a possible schizophreniform disorder and our patient was hospitalized. Shortly afterwards, an electroencephalogram showed an important subcortical epileptic activity, compatible with partial complex epilepsy with psychosensorial and psychotic symptoms. Despite a negative response to medication, symptoms proper to this type of epilepsy were substantially alleviated using a psychotherapeutical treatment intended for patients with psychotic disorders, namely integrated psychological therapy (IPT). Significant functional improvement in our patient has been achieved since then.

Conclusions

This case report illustrates that despite a negative response to medication, symptoms proper to this type of epilepsy could be substantially alleviated using psychotherapeutical treatment modalities. To the best of our knowledge, this is the first time such a finding has been reported in the scientific literature. This could open the way for new research themes and therapeutic interventions for such patients.

Keywords:
Partial complex epilepsy with psychosensorial symptoms; Integrated psychological therapy (IPT); Psychosis; Medication; Rehabilitation