• An antagonistic relationship between psychosis and seizures has been described in some patients and is sometimes termed "forced normalization." We saw seven epileptic patients without a previous psychiatric history, who developed acute psychotic states on establishment of seizure control and normalization of previously abnormal electroencephalograms with frank epileptiform activity. A possible hypothetical relationship between psychosis and epilepsy regarding the mesolimbic dopaminergic system and kindling of this system with epileptic discharge in temporal-limbic circuits could induce a florid psychotic state in some patients. This biochemical relationship to schizophrenia with heightened dopamine activity would also easily explain the amelioration of acute psychotic activity in our seven patients with neuroleptic agents and their antagonism of this increased dopaminergic outflow state.
Pakalnis A, Drake ME, John K, Kellum JB. Forced Normalization: Acute Psychosis After Seizure Control in Seven Patients. Arch Neurol. 1987;44(3):289–292. doi:10.1001/archneur.1987.00520150039018
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.