Psychiatric aspects of epilepsy

[Chronic depression and temporal lobe dysrhythmia]

Making a bibliographic review about epileptic depression, the Author found that ictal, pre, post-ictal and inter-ictal forms are described. The last one, named by Grecu and Kalman "Episodic temporal depression", is accepted as lasting for hours, days or weeks. The present work analyses two patients with episodic depression, one with permanent (3 years) and later episodic form and another with permanent depression only (13 years). The comparative study of the 4 patients, the EEG results and the effect of antiepileptic treatment permise to conclude that even the episodic and the permanent depression were of epileptic etiology, with temporal lobe localisation. Based on the symptomatology found in the 4 patients, the Author admits the hypothesis that the epileptic depression is characteristic and that it should be possible to distinguish it, clinically, from other depressions. It is suggested, for this permanent form, the name "permanent temporal depression".

Acute barbiturate poisoning in young epileptics

Two young epileptic patients presenting in coma with focal neurological signs were found to be suffering from unsuspected acute barbiturate overdose. There had been strenuous denial of any possibility of psychiatric disturbance or of self-poisoning in the history obtained from their parents at the time of admission. The importance of excluding deliberate drug overdose in any young epileptic patient presenting with prolonged or atypical coma is re-emphasized.