Andres M Kanner1, Anna Ostrovskaya. 1. Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA. akanner@rush.edu
Abstract
OBJECTIVE: The aim of this study was to determine whether postictal psychotic episodes (PIPE) are predictive of the development of interictal psychotic episodes (IPE). METHODS: This was a retrospective study of 18 consecutive adults with a partial seizure disorder and PIPE (study group) and 36 patients with a partial seizure disorder but without PIPE (control group). These two groups were compared with respect to the likelihood of developing IPE over an 8-year follow-up period and the variables operant in the development of IPE. Statistical analyses consisted of logistic regression models to identify the variables predictive of the development of IPE. Predictors included: number and location of ictal foci, seizure type, etiology, age at seizure onset, duration of seizure disorder, MRI abnormalities, and psychiatric history prior to the index video/EEG monitoring (other than PIPE). RESULTS: Seven patients with PIPE and one control patient went on to develop an IPE. Predictors of IPE in univariate logistic regression analyses included a history of PIPE (P=0.006), male gender (P=0.028), and having bilateral ictal foci (P=0.048). Significance disappeared for all of these variables when they were entered into a multivariate analysis. CONCLUSIONS: A history of PIPE may be a risk factor for the development of IPE. Yet, the disappearance of significance on multivariate analysis indicates that it is not an independent predictor.
OBJECTIVE: The aim of this study was to determine whether postictal psychotic episodes (PIPE) are predictive of the development of interictal psychotic episodes (IPE). METHODS: This was a retrospective study of 18 consecutive adults with a partial seizure disorder and PIPE (study group) and 36 patients with a partial seizure disorder but without PIPE (control group). These two groups were compared with respect to the likelihood of developing IPE over an 8-year follow-up period and the variables operant in the development of IPE. Statistical analyses consisted of logistic regression models to identify the variables predictive of the development of IPE. Predictors included: number and location of ictal foci, seizure type, etiology, age at seizure onset, duration of seizure disorder, MRI abnormalities, and psychiatric history prior to the index video/EEG monitoring (other than PIPE). RESULTS: Seven patients with PIPE and one control patient went on to develop an IPE. Predictors of IPE in univariate logistic regression analyses included a history of PIPE (P=0.006), male gender (P=0.028), and having bilateral ictal foci (P=0.048). Significance disappeared for all of these variables when they were entered into a multivariate analysis. CONCLUSIONS: A history of PIPE may be a risk factor for the development of IPE. Yet, the disappearance of significance on multivariate analysis indicates that it is not an independent predictor.