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July 18, 1977

Complex Partial Seizures vs Schizophrenia

JAMA. 1977;238(3):211. doi:10.1001/jama.1977.03280030018004

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To the Editor.—  The report by Adebimpe concerning a man who was thought to have complex partial seizures simulating schizophrenia underscores a trend among many psychiatrists to ascribe organic causes for apparent emotionally aberrant behavior. The report also supports my feeling, however, that this trend often leads one into a confusing area that is neither psychiatric or neurologic.Based on the case report, the evidence to support complex partial epilepsy is much less than satisfactory. The episodes last approximately three hours and as long as 24 hours, rather long for seizures. They are said to have "aura-like" phases that last as long as four hours. They are not followed by any confusion, and they are characterized by goal-directed destructive behavior as part of the ictal period. These features are all highly atypical of temporal lobe seizures. Further, the inability to obtain an abnormal EEG and the response of these "seizures"