New research suggests similar brain patterns in seizure-linked psychosis and schizophrenia
Latest research at the Epilepsy Society, using pioneering research equipment, has shown parallels between people with seizure-linked psychosis and schizophrenia.
About 5.6 % of people with epilepsy suffer from psychosis, a mental health condition which includes symptoms such as hallucinations, delusions and disorganised thinking.
One of the most common forms of psychosis linked to seizures is postictal psychosis, otherwise known as PIP. This affects around 2% of people with epilepsy and typically appears within one week after a seizure, with symptoms including severe agitation, aggression towards others, self-harm and violent behaviour. Severe consequences can include injury, hospitalisation, or even criminal convictions.
Although postictal psychosis is poorly understood, genomic and neuroimaging studies have suggested parallels with schizophrenia.
Similar patterns of brain activity
Our researchers have been looking at this challenging and understudied population to determine whether there are any schizophrenia-type changes in in the brains of people with postictal psychosis. They have been using an advanced brain monitoring tool – Transcranial Magnetic Stimulation with EEG (TMS-EEG). This technology helps scientists investigate how brain cells respond to stimulation, giving insight into the balance between brain excitation and inhibition.
The study, led by Simona Balestrini* involved a small group. Researchers looked at seven people with epilepsy who also had Postictal Psychosis, and 14 people with epilepsy but without a previous history of psychosis. Preliminary findings revealed that those with postictal psychosis showed patterns of brain activity similar to those seen in schizophrenia.
Importantly, researchers believe that this is the first time that TMS-EEG has been used to study people with this type of psychosis and suggest that it could be an appropriate research technique for further studies in this group of people.
This would enable larger studies that can improve risk assessment, support the development of new treatments, and deepen understanding of the brain changes that underlie postictal psychosis. However, they also stress the importance of making studies like this more accessible — by keeping testing sessions comfortable, including regular breaks, and ensuring travel support for participants who may not be able to drive or travel independently.
*Simona Balestrini is Senior Clinical Research Fellow and Consultant Neurologist,Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, National Hospital for Neurology and Neurosurgery and Chalfont Centre for Epilepsy. She is also Associate Professor of Child Neurology and Psychiatry
Neuroscience and Medical Genetics Department, Meyer Children's Hospital IRCSS- University of Florence.