TITLE:
Ictal Psychosis under Disguise of Mania: How to Unravel
AUTHORS:
Abdelgadir H. Osman, Sabah M. Alsharief
KEYWORDS:
Ictal Psychosis, Ictal Mania, Frontal Lobe Ictal Psychosis
JOURNAL NAME:
Open Journal of Psychiatry,
Vol.10 No.4,
October
20,
2020
ABSTRACT: Background: Ictal psychosis without remarkable cognitive impairment is uncommon occurrence, presents diagnostic challenges to clinicians, often misdiagnosed as functional psychosis. Case Presentation: We present 3 cases of young adult men admitted to psychiatric ward as functional psychosis. They presented with irritability, physical aggression and mild cognitive impairment with intense emotional symptoms, and persecutory ideas and delusions. Two were wrongly diagnose as mania while the third was mimicking schizophrenia in its presentation. They received antipsychotic treatment and misdiagnosed as functional psychosis. They did not respond well to such treatment, until, series electroencephalograms were taken which revealed evidence of ictal psychosis. All, thence, responded well to addition of antiepileptic treatment. This, not only, proves to be effective, but also determined future management and prognosis. Conclusion: These cases shine light onto the role of the frontal cortex in the genesis of quasi-manic episodes and highlight the importance of EEG investigations in first episode of acute psychosis.