Hiding in Plain Sight: A case of post ictal psychosis with suicidal behavior

Postictal psychosis (PIP) is a serious, often unrecognized complication of epilepsy. Early diagnosis and intervention can prevent life-threatening outcomes. We report the case of a 26-year-old woman with childhood-onset frontal lobe epilepsy who attempted suicide, during a postictal psychotic episod...

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Main Authors: Tamara Fischl, Piero Perucca
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Epilepsy & Behavior Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2589986424000844
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author Tamara Fischl
Piero Perucca
author_facet Tamara Fischl
Piero Perucca
author_sort Tamara Fischl
collection DOAJ
description Postictal psychosis (PIP) is a serious, often unrecognized complication of epilepsy. Early diagnosis and intervention can prevent life-threatening outcomes. We report the case of a 26-year-old woman with childhood-onset frontal lobe epilepsy who attempted suicide, during a postictal psychotic episode, several days after undergoing inpatient video-EEG monitoring. This case presents a real-world scenario with clear guidelines for the on-call neurologist who will need to accurately diagnose and confidently manage PIP with psychotropic medications. Moreover, this case may stimulate discussion about the complex relationship between epilepsy and psychosis.
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spelling doaj-art-da57cf41de3a450086476db6c0b8367f2025-08-20T02:47:36ZengElsevierEpilepsy & Behavior Reports2589-98642025-03-012910072710.1016/j.ebr.2024.100727Hiding in Plain Sight: A case of post ictal psychosis with suicidal behaviorTamara Fischl0Piero Perucca1Neuropsychiatry of Epilepsy Clinic Pediatric Neurology Outpatient Clnic Edmond and Lily-Safra Children’s Hospital, Sheba Medical Center-Tel Aviv, Israel; Corresponding author at: Israel Stroke Centre, Israel.Epilepsy Research Centre, Department of Medicine (Austin Health), The University of Melbourne, Melbourne, Victoria, Australia; Bladin-Berkovic Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Melbourne, Victoria, Australia; Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia; Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Victoria, AustraliaPostictal psychosis (PIP) is a serious, often unrecognized complication of epilepsy. Early diagnosis and intervention can prevent life-threatening outcomes. We report the case of a 26-year-old woman with childhood-onset frontal lobe epilepsy who attempted suicide, during a postictal psychotic episode, several days after undergoing inpatient video-EEG monitoring. This case presents a real-world scenario with clear guidelines for the on-call neurologist who will need to accurately diagnose and confidently manage PIP with psychotropic medications. Moreover, this case may stimulate discussion about the complex relationship between epilepsy and psychosis.http://www.sciencedirect.com/science/article/pii/S2589986424000844EpilepsyPost-ictal psychosisPsychosis
spellingShingle Tamara Fischl
Piero Perucca
Hiding in Plain Sight: A case of post ictal psychosis with suicidal behavior
Epilepsy & Behavior Reports
Epilepsy
Post-ictal psychosis
Psychosis
title Hiding in Plain Sight: A case of post ictal psychosis with suicidal behavior
title_full Hiding in Plain Sight: A case of post ictal psychosis with suicidal behavior
title_fullStr Hiding in Plain Sight: A case of post ictal psychosis with suicidal behavior
title_full_unstemmed Hiding in Plain Sight: A case of post ictal psychosis with suicidal behavior
title_short Hiding in Plain Sight: A case of post ictal psychosis with suicidal behavior
title_sort hiding in plain sight a case of post ictal psychosis with suicidal behavior
topic Epilepsy
Post-ictal psychosis
Psychosis
url http://www.sciencedirect.com/science/article/pii/S2589986424000844
work_keys_str_mv AT tamarafischl hidinginplainsightacaseofpostictalpsychosiswithsuicidalbehavior
AT pieroperucca hidinginplainsightacaseofpostictalpsychosiswithsuicidalbehavior