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The True Meaning of Eeg Epileptic Activity in a Patient with Schizophrenia Treated with Clozapine

Published online by Cambridge University Press:  15 April 2020

A. Leal
Affiliation:
Neurophisiology, Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal

Abstract

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The relation between schizophrenia and epilepsy has always been a matter of great interest, not only because of their increased correlation, but also from the point of view of neuropathology, and, as is in this case, from the point of differential diagnosis and of the therapeutic options. We present an interesting case of a patient of forty with the first schizo-morphous episode characterized by a capgras Sindrome, who was starting to be aggressive with her parents and had to be compulsively admitted. The patient had no past of toxics use, neither had family anteecedents. Few days after her readdmission, she developed a seizure without any eye witness. There weren't any signs of lost of consciousness. When she repeated the EEG- urgent, it was patent a diffuse Activity as can be seen in image 1.

How can we understand this activity ? the hypothesis of schizophrenia had to change to Secondary psychosis. A RNM CE was done to better clarify this question. In the meanwhile all the clozapine was taken off and EEG returned to normal vidé images two and three.

In fact, we tried to think about this case and we concluded that probably that activity was secondary to clozapine. Specially given her antecedents of epilepsy in her chidwood . However the only way of being sure was if it was asked for prolactinemia in three differents times 20 and 30 and 40 ‘, which should show a spike between 30 and 20 ´ after the crisis.

Type
Article: 1765
Copyright
Copyright © European Psychiatric Association 2015
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