A case report of dacrystic seizures presenting with psychosis

Authors

  • Aysha Zabin M Madathil Junior Resident, Department of Psychiatry, Government Medical College, Kozhikode
  • Anithakumari Ayirolimeethal Additional Professor, Department of Psychiatry, Government Medical College, Kozhikode
  • Pankajakshan Vijayanthi Indu Additional Professor, Department of Psychiatry, Government Medical College, Kozhikode

DOI:

https://doi.org/10.30834/KJP.33.1.2020.199

Keywords:

dacrystic seizures, epileptic crying, psychosis

Abstract

Dacrystic seizures present with sudden bursts of crying and often manifest with comorbid psychiatric symptoms. Here, we present the case of a 27-year-old female with an 11-year history of stereotyped patterns of crying spells, associated with fearfulness, suspicions, hallucinatory behaviour, recurrent suicidal gestures and impairment in functioning.  She was treated mostly with antipsychotics, antidepressants and mood stabilizers (for a brief period) irregularly, without adequate improvement. She presented with catatonia, hypokalemia and aspiration pneumonia, following default of medications for one month. With appropriate treatment, her physical condition became stable, when short-lasting bouts of recurrent crying spells were observed, followed by confused behaviour and sleep, along with delusions and hallucinations. Her EEG showed epileptiform discharges; brain imaging was normal. She showed good response to anticonvulsants along with antipsychotics. Such unusual presentations of epilepsy and comorbid psychiatric symptoms warrant a high index of suspicion, for proper diagnosis and management.

References

Asadi-Pooya AA, Wyeth D, Sperling MR. Ictal crying. Epilepsy Behav 2016; 59:1–3.

Offen ML, Davidoff RA, Troost BT, Richey ET. Dacrystic epilepsy. J Neurol Neurosurg Psychiatry 1976; 39:829–34.

Blumberg J, Fernandez IS, Vendrame M, Oehl B, Tatum WO, Schuele S, et al. Dacrystic seizures: Demographic, semiological, and etiological insights from a multicenter study in long-term video-EEG monitoring units. Epilepsia 2012;53(10):1810–19.

Verma R, Praharaj HN. Reflex gelastic-dacrystic seizures following hypoxic-ischaemic encephalopathy. BMJ Case Reports. 2013 ;2013. Available from: doi: 10.1136/bcr-2013-010506

Duarte Mangas M, Martins Y, Bravo L, Matos Pires A. Misdiagnoses of Epilepsy as Ekbom Syndrome, Mood Instability, and Nocturnal Visual Hallucinations. Vol. 2017, Case reports in psychiatry. 2017. p. 3968751. Available from: https://doi.org/10.1155/2017/3968751.

Striano S, Striano P. Clinical features and evolution of the gelastic seizures-hypothalamic hamartoma syndrome. Epilepsia 2017;58(2):12-5.

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Published

2020-07-01

How to Cite

Madathil, A. Z. M., Ayirolimeethal, A. ., & Indu, P. V. (2020). A case report of dacrystic seizures presenting with psychosis. Kerala Journal of Psychiatry, 33(1), 64–68. https://doi.org/10.30834/KJP.33.1.2020.199

Issue

Section

Case Report