Psychiatry and Clinical Psychopharmacology

Schizophrenia and other psychotic disorders A case report: psychosis after vagal nervus stimulation

Psychiatry and Clinical Psychopharmacology 2013; 23: Supplement S241-S241
Read: 815 Published: 17 March 2021

Psychiatric symptoms are usually seen in epilepsy disorder. Irritability, depression, anxiety, euphoria and insomnia are among the most common. These symptoms can be interictal, preictal, ictal and postictal. Psychotic symptoms consist of hallucinations and delusions. It’s commonly stated in literature that after controlling seizures by antiepileptic drugs or other methods and also yielding a normal EEG, psychiatric symptoms can occur (Forced normalization phenomenia). Vagal nerve stimulation (VNS) is a method that can be applied to patients, who are resistant to antiepileptic drugs or not eager to go under surgery. A few cases can be found in the literature where patients have psychosis after VNS. A male patient was twenty years old. His epileptic seizures started when he was eight. Seizures were treated by different combination of antiepileptic drugs since twelve years but interventions failed. Frequency of patient’s seizures vanished slowly after vagal nerve stimulation, which was done in December 2012. At the same time, he became withdrawn and he started hallucinating about insects and snakes. The frightening feeling of seeing these made him unable to sleep. These symptoms continued about a month and a half after, which he came to the psychiatry clinic to have diagnosis and treatment. When he came to our department his conscious was open and was able to make limited eye contact. He had anxiety and irritability because of his visual hallucinations. There was no hemisphere asymmetry or paroxysmal activity in EEG. Haloperidol 10 mg/day and biperiden 4mg/day were started. He could make proper eye contact again after about three weeks and he achieved to be compatible in his progression. His visual hallucinations disappeared and no psychotic symptoms occurred again. There were no periods in patient’s life lacking psychotic signs. He has been using antiepileptic medicines for a long time. His psychotic symptoms became visible after we definitely could get his seizures under control by VNS. It is thought that substantial condition in our patient is coherent with forced normalization phenomena because of the fact that no epileptic activity was seen in EEG too.
 

EISSN 2475-0581