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Psychotic Episode (psychotic + episode)
Kinds of Psychotic Episode Selected AbstractsOestrogen withdrawal associated psychosesACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2001V. Mahé Objective: Oestrogen withdrawal has been hypothesized as playing a causal role in puerperal psychoses. However, oestrogen withdrawal exists in conditions others than puerperium. We searched the published case reports where a decrease in oestrogen levels not occurring during puerperium was associated with a psychotic disorder, in order to evaluate the relevance of this hypothesis. These cases were defined as oestrogen withdrawal associated psychoses. Method: A systematic research of the literature was conducted for the period 1960,2000. Results: We identified 26 observations reporting an association between a psychotic disorder and a phase of oestrogen withdrawal. Psychotic episodes were short and reversible with recurrences reported when oestrogen withdrawal recurred. Puerperal psychosis was frequently reported in the history of patients. Conclusion: The oestrogen withdrawal hypothesis can be extended to certain psychotic episodes not occurring during in puerperium. This provides an additional argument for the clinical relevance of oestrogen withdrawal in puerperal and related psychoses. [source] Prevalence and correlates of comorbidity 8 years after a first psychotic episodeACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2007S. Farrelly Objective:, While rates and correlates of comorbidity have been investigated in the early course of psychosis, little is known about comorbidity in the medium-to-longer term or its relationship with outcome. Method:, A total of 182 first-episode psychosis (FEP) patients who met DSM-IV criteria for a current psychotic disorder 8 years after index presentation were grouped according to concurrent comorbidity [no concurrent axis I disorder; concurrent substance use disorder (SUD); other concurrent axis I disorder; concurrent SUD and other axis I disorder]. Outcomes were compared between groups controlling for relevant covariates. Results:, As much as 39% met criteria for one or more concurrent axis 1 diagnoses. Comorbidity was associated with greater severity of general psychopathology, but not with measures of functioning, treatment or negative symptoms. Conclusion:, Specific combinations of comorbid disorders may influence patterns of psychotic symptomatology. Routine examination of axis I disorders is warranted in the ongoing management of psychosis. [source] Does antipsychotic withdrawal provoke psychosis?ACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2006Review of the literature on rapid onset psychosis (supersensitivity psychosis), withdrawal-related relapse Objective:, To examine the evidence that discontinuation of long-term antipsychotic medication, including clozapine, may provoke a psychotic episode. Method:, Databases were searched and citations scrutinised. Results:, Evidence for a rapid onset psychosis (supersensitivity psychosis) following clozapine withdrawal was found and weaker evidence that this might occur with some other antipsychotic drugs. Some cases were reported in people without a psychiatric history. It appears that the psychosis may be a feature of drug withdrawal rather than the re-emergence of an underlying illness, at least in some patients. Meta-analyses of withdrawal studies have suggested that antipsychotic discontinuation may also increase the risk of relapse over and above the risk because of the underlying disorder, but not all individual studies show this effect. Mechanisms may relate to brain adaptations to long-term drug use but data are sparse. Conclusion:, These effects require further urgent research. Interventions to reduce morbidity after drug withdrawal need to be developed. [source] Assessing prolonged recovery in first-episode psychosisACTA PSYCHIATRICA SCANDINAVICA, Issue 2002L. Wong The Early Psychosis Prevention and Intervention Centre (EPPIC) is a comprehensive, specialized treatment service for individuals residing in the western metropolitan region of Melbourne who are experiencing their first psychotic episode. A subprogramme of EPPIC, the Treatment Resistance Early Assessment Team (TREAT), has been developing a framework for the management of individuals experiencing ,prolonged recovery' in early psychosis. TREAT is a consultation team that provides technical assistance to clinicians within EPPIC, comprising senior clinicians with expertise in the biopsychosocial treatment of early psychosis and persisting positive and negative symptoms. A system has recently been set up within the TREAT framework to routinely assess clinical and functional outcomes of these clients using standardized instruments. Case managers are trained to conduct assessments at multiple timepoints over the duration of their clients' treatment at EPPIC. A summary will be presented on the current sample (n=15) and examples of clinician and client feedback reports will be illustrated. Discussion is also provided on the development of training, procedures and materials to enhance integration of clinician and client outcome measures into routine clinical practice. [source] Diagnoses at the first psychotic episode and cognitive functioningACTA PSYCHIATRICA SCANDINAVICA, Issue 2002J. Addington Objectives, To determine the relationship between diagnosis and cognitive functioning in a first-episode sample. Methods, 175 subjects were diagnosed (SCID) on admission to a comprehensive treatment programme for early psychosis and 1 year later. Symptoms (PANSS), social functioning and cognitive functioning (using a comprehensive cognitive battery) were assessed initially and at 1 year. Subjects were divided into three groups: (1) Stable diagnosis of schizophrenia over 1 year (n=84). (2) Initial diagnosis of schizophreniform, brief psychotic disorder, substance induced psychosis or psychosis NOS but who met criteria for schizophrenia at 1 year (n=49) and (3) Stable diagnosis over 1 year of schizophreniform, brief psychotic disorder, substance induced psychosis or psychosis NOS (n=44). Results, There were significant differences amongst the three groups at both assessment periods in positive and negative symptoms and social functioning. There were no differences amongst the groups in cognitive functioning. Conclusions, Individuals with psychotic disorders who do not go on to develop schizophrenia do not differ significantly in neurocognition from those who do develop schizophrenia, although they may have advantages in other areas. [source] Early diagnosis of schizophrenia , the first step towards secondary preventionACTA PSYCHIATRICA SCANDINAVICA, Issue 400 2000M. Davidson Objective: To review current knowledge of risk factors associated with schizophrenia and the development of diagnostic markers aimed at the delay or attenuation of the first psychotic episode. Method: Studies relating to the development of disease and the risk factors that could inform predictive markers are reviewed, including high-risk studies, birth-cohort studies, and retrospective and follow-back studies. Results: Future schizophrenic patients present with delayed developmental milestones, speech and behavioural difficulties, and lower IQ scores than non-cases. Conclusion: Results are consistent with the notion that schizophrenia is a developmental disease and that such antecedents are present; further research is required to improve the specificity of diagnostic markers and predictive power before these can be used to prevent or delay psychotic episodes of schizophrenia. [source] Early intervention with second-generation antipsychotics in first-episode psychosis: results of an 8-week naturalistic studyEARLY INTERVENTION IN PSYCHIATRY, Issue 1 2010Richard C. Josiassen Abstract Objective: The objective was to compare short-term effectiveness of aripiprazole with three other second-generation antipsychotics (SGAs) in the treatment of first-episode psychosis. Method: In a naturalistic, ,single-blind' design, 60 subjects experiencing their first psychotic episode were treated for 8 weeks with aripiprazole (n = 19), risperidone (n = 16), olanzapine (n = 14) or quetiapine (n = 11). Medication and dosing decisions were made by treating psychiatrists, constrained to once-a-day dosing, low initial doses and no clozapine. Weekly ratings were obtained using the Positive and Negative Syndrome Scale (PANSS), Simpson-Angus Rating Scale and Barnes Akathasia Rating Scale. Weight and vital signs were also collected weekly. Results: The group presented with severe psychotic symptoms (mean baseline PANSS total score of 105.2), which were reduced rapidly (P < 0.0005). The between-group and group by time interaction terms were non-significant. Similar reductions were seen across all PANSS sub-scales. At Week 1 the mean PANSS Activation Scale score was reduced more with olanzapine than in the other groups (P < 0.002). Few instances of extrapyramidal symptoms occurred; all were sporadic and did not require treatment. Group body weight increased by 7.3% over the study. Vital signs remained unchanged. Conclusions: Early intervention with low doses of four SGAs led to rapid symptom reduction in first-episode psychotic patients with severe psychopathology. Although no clear medication advantages were observed in the short term, longer duration studies with larger samples will be required for determining efficacy, rates of compliance, relapse prevention and diminished incidence of extrapyramidal signs and symptoms. [source] A single application of MK801 causes symptoms of acute psychosis, deficits in spatial memory, and impairment of synaptic plasticity in ratsHIPPOCAMPUS, Issue 2 2008Denise Manahan-Vaughan Abstract Schizophrenia is mostly a progressive psychiatric illness. Although cognitive changes in chronic schizophrenia have been investigated, little is known about the consequences of a single psychotic episode on memory mechanisms and formation. We investigated changes in hippocampal long-term potentiation (LTP) and spatial memory in a rat model of an acute psychotic episode. Application of NMDA receptor antagonists, such as MK801 (dizolcilpine) in rats, have been shown to give rise to an acute and short-lasting behavioral state, which mirrors many symptoms of schizophrenia. Furthermore, NMDA antagonist-intake in humans elicits symptoms of schizophrenia such as hallucinations, delusions, and affective blunting. We therefore treated animals with a single systemic injection of MK801 (5 mg/kg). Increased stereotypy, locomotion, and ataxia were evident immediately after MK801-treatment, with effects disappearing within 24 h. MK801-treatment caused a disruption of prepulse inhibition of the acoustic startle reflex, 1 day but not 7 or 28 days after treatment. These effects were consistent with the occurrence of an acute psychotic episode. LTP was profoundly impaired in freely moving rats 7 days after MK801 application. Four weeks after treatment, a slight recovery of LTP was seen, however marked deficits in long-term spatial memory were evident. These data suggest that treatment with MK801 to generate an acute psychotic episode in rats, gives rise to grave disturbances in synaptic plasticity and is associated with lasting impairments with the ability to form spatial memory. © 2007 Wiley-Liss, Inc. [source] Superior temporal lobe dysfunction and frontotemporal dysconnectivity in subjects at risk of psychosis and in first-episode psychosisHUMAN BRAIN MAPPING, Issue 12 2009Nicolas A. Crossley Abstract Background: Superior temporal lobe dysfunction is a robust finding in functional neuroimaging studies of schizophrenia and is thought to be related to a disruption of fronto-temporal functional connectivity. However, the stage of the disorder at which these functional alterations occur is unclear. We addressed this issue by using functional MRI (fMRI) to study subjects in the prodromal and first episode phases of schizophrenia. Methods: Subjects with an at risk mental state (ARMS) for psychosis, a first psychotic episode (FEP), and controls were studied using fMRI while performing a working memory task. Activation in the superior temporal gyrus (STG) was assessed using statistical parametric mapping, and its relationship to frontal activation was examined using dynamic causal modeling. Results: The STG was differentially engaged across the three groups. There was deactivation of this region during the task in controls, whereas subjects with FEP showed activation and the response in subjects with ARMS was intermediately relative to the two other groups. There were corresponding differences in the effective connectivity between the STG and the middle frontal gyrus across the three groups, with a negative coupling between these areas in controls, a positive coupling in the FEP group, and an intermediate value in the ARMS group. Conclusions: A failure to deactivate the superior temporal lobe during tasks that engage prefrontal cortex is evident at the onset of schizophrenia and may reflect a disruption of fronto-temporal connectivity. Qualitatively similar alterations are evident in people with prodromal symptoms of the disorder. Hum Brain Mapp, 2009. © 2009 Wiley-Liss, Inc. [source] Young infants' triangular communication with their parents in the context of maternal postpartum psychosis: Four case studies,INFANT MENTAL HEALTH JOURNAL, Issue 4 2009Diane Philipp With increasing data on the dynamics of normative couples as they transition to parenthood and become a triad, the need for greater understanding of the impact of parental psychopathology on this transition has become clear. The goal of the current article is to begin exploring this area that has received little attention to date, by describing case examples from a study of clinical families as they transitioned to parenthood. Four representative cases were selected from a pool of 13 mother,father,baby triads, for whom the mother had been hospitalized conjointly with her infant due to a psychotic episode during the postpartum period. The families were observed as part of a clinical consultation that included a semistructured play paradigm known as the Lausanne Trilogue Play (LTP; E. Fivaz-Depeursinge, & A. Corboz-Warnery, 1999). Interactions were scored using standardized measures as well as clinical impressions. All families from the clinical sample were noted to struggle and frequently failed to achieve the goals of play. The impact on the infants in terms of their developing sense of self as well as their defensive strategies in this context are discussed, with clinical implications explored. [source] Developing services for the carers of young adults with early-onset psychosis , listening to their experiences and needsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 5 2005J. SIN msc bsc (hons)-thorn bn bgs rmn The care-giving experience of carers of young adults with early onset psychosis is relatively unexplored. New carers are less likely to be engaged with local services for carers and families, than those more established in their caring role. Understanding the experience of these carers provides some valuable insight into the value of caring and in guiding service development. This paper reports on a study designed to explore carers' experiences of caring for a young adult diagnosed with a first psychotic episode and their needs in relation to the development of an early intervention for psychosis service. A phenomenological approach was used. Eleven carers were given a semi-structured interview in their own homes. All of the carers in the study had a son with early onset psychosis. The outcome revealed that all carers were providing a comprehensive range of practical, emotional and financial support for their son including initiating and sustaining engagement between them and local mental health services. Many carers were felt to be invisible and silent partners in care and felt under-valued by mental health services. [source] Early prodromal symptoms and diagnoses before first psychotic episode in 219 inpatients with schizophreniaPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 4 2007TOSHIKI SHIOIRI md Abstract The authors examined the diagnosis before the onset of schizophrenia and retrospectively evaluated the presence/absence of early prodromal symptoms (EPS) and their types (such as depressive symptoms, anxiety symptoms, and obsessive-compulsive [OC] symptoms) and the period from the onset of these symptoms to that of schizophrenia in 219 inpatients with schizophrenia diagnosed according to the DSM-IV(-TR). A diagnosis was made before the onset of schizophrenia in 53 patients (24.2%). The diagnoses were mood disorder in 39 patients, anxiety disorder in seven, obsessive-compulsive disorder (OCD) in three, adjustment disorder in two, and eating disorder in two. EPS were present in 65 (29.7%) of all patients, slightly more frequent in female patients (male : female = 1:1.41). In the group with EPS, depressive symptoms (61.5%) were most frequently observed, followed by anxiety symptoms (23.1%) and OC symptoms (9.2%). The age at onset for each type of symptom was significantly lower for OC symptoms (14.5 ± 2.4 years) than for the other symptoms (approx. 20 years). The mean period from the onset of each symptom to that of schizophrenia was the shortest for depressive symptoms (2.7 ± 3.1 years) and the longest (>4 years) for OC symptoms. These results as well as previous studies in Western countries showed that more non-specific and general symptoms are frequently present for some years before the onset of schizophrenia. With consideration of this point, efforts toward early detection of schizophrenia are important. [source] Low IQ scores in schizophrenia: primary or secondary deficit?ACTA NEUROPSYCHIATRICA, Issue 3 2002M. Van Beilen Background: Schizophrenia is consistently associated with lower IQ compared to the IQ of control groups, or estimated premorbid IQ. It is not likely that the IQ scores deteriorate during the prodromal phase or first psychotic episode; they are already present before the onset of the prodromal phase and have been detected in childhood. Methods: We investigated cognitive functioning and IQ levels in a group of 36 patients with schizophrenia or other psychotic disorders. Results: The IQ scores in our sample were lower than average. The IQ showed a relation with attention, memory, speed of information processing and some aspects of executive functioning. However, when IQ scores were corrected for processing speed, they were no longer below average. Conclusions:, These findings are important in considering the value of intelligence levels in schizophrenia. IQ scores should be judged in combination with cognitive functioning and school career to assess a patients capabilities in society. Cognitive functions and other variables might have a considerable influence on IQ scores. This rises the question of whether the low IQ scores are a primary or secondary deficit. Schizophrenia patients may have normal IQs, but could be less capable of making an IQ-test. [source] Are multi family groups appropriate for patients with first episode psychosis?ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010A 5-year naturalistic follow-up study Rossberg JI, Johannessen JO, Klungsoyr O, Opjordsmoen S, Evensen J, Fjell A, Haahr U, Joa I, Langeveld J, Larsen TK, Melle I, Rund BR, Simonsen E, ten Velden W, Vaglum P, Friis S, McGlashan T. Are multi family groups appropriate for patients with first episode psychosis? A 5-year naturalistic follow-up study. Objective:, To compare outcome over 5 years for patients who participated in multi family groups (MFGs) to those who refused or were not offered participation. Method:, Of 301 first episode psychotic patients aged 15,65 years, 147 participated in MFGs. Outcome was measured by drop-out rates, positive and negative syndrome scale (PANSS) symptom scores, and duration of psychotic episodes during the follow-up period. Results:, Multi family group participants had a significantly lower drop-out rates at 5-year follow-up than patients who did not participate. However, the MFG participants had significantly less improvement in PANSS positive and excitative symptoms and had significantly longer duration of psychotic symptoms during the follow-up period. Conclusion:, Multi family groups appear to increase the chance of retaining patients in a follow-up study, but adjustment of the programme may be necessary with first episode psychosis patients to meet their needs better. [source] Oestrogen withdrawal associated psychosesACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2001V. Mahé Objective: Oestrogen withdrawal has been hypothesized as playing a causal role in puerperal psychoses. However, oestrogen withdrawal exists in conditions others than puerperium. We searched the published case reports where a decrease in oestrogen levels not occurring during puerperium was associated with a psychotic disorder, in order to evaluate the relevance of this hypothesis. These cases were defined as oestrogen withdrawal associated psychoses. Method: A systematic research of the literature was conducted for the period 1960,2000. Results: We identified 26 observations reporting an association between a psychotic disorder and a phase of oestrogen withdrawal. Psychotic episodes were short and reversible with recurrences reported when oestrogen withdrawal recurred. Puerperal psychosis was frequently reported in the history of patients. Conclusion: The oestrogen withdrawal hypothesis can be extended to certain psychotic episodes not occurring during in puerperium. This provides an additional argument for the clinical relevance of oestrogen withdrawal in puerperal and related psychoses. [source] Early diagnosis of schizophrenia , the first step towards secondary preventionACTA PSYCHIATRICA SCANDINAVICA, Issue 400 2000M. Davidson Objective: To review current knowledge of risk factors associated with schizophrenia and the development of diagnostic markers aimed at the delay or attenuation of the first psychotic episode. Method: Studies relating to the development of disease and the risk factors that could inform predictive markers are reviewed, including high-risk studies, birth-cohort studies, and retrospective and follow-back studies. Results: Future schizophrenic patients present with delayed developmental milestones, speech and behavioural difficulties, and lower IQ scores than non-cases. Conclusion: Results are consistent with the notion that schizophrenia is a developmental disease and that such antecedents are present; further research is required to improve the specificity of diagnostic markers and predictive power before these can be used to prevent or delay psychotic episodes of schizophrenia. [source] Interictal Psychoses in Comparison with Schizophrenia,A Prospective StudyEPILEPSIA, Issue 12 2007Yukari Tadokoro Summary Purpose: To prospectively investigate the incidence of interictal psychoses of epilepsy patients, and make a comparison between those with interictal psychoses and patients with schizophrenia in respect to their responses to antipsychotic drugs, as well as psychotic states. Methods: We undertook a two-part prospective investigation. In Part I, the psychotic episodes of 619 epilepsy patients were investigated, while 182 patients with psychotic syndromes were followed in Part II, of whom 59 were diagnosed with schizophrenia and 13 with epilepsy with interictal psychoses. The Positive and Negative Syndrome Scale was used for efficacy assessment. Results: The average annual incidence of interictal psychosis was 0.42% during the 56-month study period. A significant difference was found between patients with schizophrenia and epilepsy patients with interictal psychoses in respect to results on the negative subscale of the PANSS at the initial examination (mean scores of 18.1 and 13.2, respectively, p = 0.004). The response rates one year later for these groups were 27.1% and 53.8%, respectively, which showed a trend of better response to the antipsychotic medication by the epilepsy group (p = 0.098). Initial and maximum doses of antipsychotic drugs used for epilepsy patients with interictal psychoses were significantly lower than those used for patients with schizophrenia (p = 0.008 and p = 0.006, respectively). Conclusions: Schizophrenia and epileptic psychosis showed different symptom profiles. On average, epilepsy patients with interictal psychoses achieved higher remission rates with lower doses of antipsychotic drugs as compared to patients with schizophrenia in the present 1-year follow-up study. [source] Synthesis and radiolabelling of [123I]-4-iodo-N-(4-(4-(2-methoxyphenyl)-piperazin-1-yl)butyl)-benzamide, a potential dopamine D3 antagonist for SPECT studiesJOURNAL OF LABELLED COMPOUNDS AND RADIOPHARMACEUTICALS, Issue 4 2003L. Staelens Abstract Schizophrenia is a devastating mental disorder characterized by relapsing psychotic episodes accompanied with emotional, professional and social decline. The classical dopamine hypothesis of schizophrenia postulates that hyperactivity of dopaminergic neurotransmission is responsible for the positive symptoms of the disorder. More exactly hyperactivity of the dopamine D3 receptor system is thought to be involved in the pathology of schizophrenia. Therefore a new 123I-labelled compound was developed which may allow in vivo visualization of the D3 receptor by SPECT. [123I]-4-iodo- N -(4-(4-(2-methoxyphenyl)-piperazin-1-yl)butyl)-benzamide was synthesized and labelled by electrophilic aromatic substitution of the tributylstannyl derrivative. The radiochemical yield was 82,85% and the specific activity was >2.96 Ci/µmol. Copyright © 2003 John Wiley & Sons, Ltd. [source] A pilot study using nabilone for symptomatic treatment in Huntington's disease,MOVEMENT DISORDERS, Issue 15 2009Adrienne Curtis BSC Abstract Pilot study of nabilone in Huntington's disease (HD). Double-blind, placebo-controlled, cross-over study of nabilone versus placebo. Primary outcome, Unified Huntington's Disease Rating Scale (UHDRS) total motor score. Secondary measures: UHDRS subsections for chorea, cognition and behavior, and neuropsychiatric inventory (NPI). 44 randomized patients received either nabilone (1 or 2 mg) followed by placebo (n = 22), or placebo followed by nabilone (n = 22). Recruiting was straightforward. Nabilone safe and well tolerated, no psychotic episodes. Assessment of either dose of nabilone versus placebo showed a treatment difference of 0.86 (95% CI: ,1.8 to 3.52) for total motor score; 1.68 (95% CI: 0.44 to 2.92) for chorea; 3.57 (95% CI: ,3.41 to 10.55) for UHDRS cognition; 4.01 (95% CI: ,0.11 to 8.13) for UHDRS behavior, and 6.43 (95% CI: 0.2 to 12.66) for the NPI. Larger longer RCT of nabilone in HD is feasible and warranted. © 2009 Movement Disorder Society [source] Sociodemographic and clinical factors associated with relapse in schizophreniaPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 6 2007GOBIND CHABUNGBAM md Abstract The aim of the present study was to examine sociodemographic and clinical factors associated with relapse in schizophrenia. The study group consisted of a convenience sample of 40 schizophrenia patients (20 patients each in relapse and remission). Relapse and remission were defined based on clinical criteria (ICD-10 criteria, course since last episode, and duration of remission) and psychometric criteria (scores on Socio-Occupational Functioning Assessment Scale [SOFAS] and Positive and Negative Syndrome Scale for Schizophrenia [PANSS]). The index group was evaluated after the occurrence of current relapse but within 6 months of its onset. Sociodemographic, current psychopathology (PANSS) and functioning (SOFAS), and other (mainly retrospective) variables were assessed with a specifically designed clinical profile sheet, Schedule for Affective Disorders and Schizophrenia Lifetime version, Presumptive Stressful life Events Scale, and World Health Organization Life Chart Schedule for Assessment of Course and Outcome of Schizophrenia. Patients who had relapsed were more symptomatic and exhibited greater dysfunction in comparison to remitted patients. Relapse in schizophrenia was significantly associated with unemployment, number of psychotic episodes, side-effects of medication, and life events score. The present findings suggest that a severe illness (no. psychotic episodes, unemployment), psychological stress and inappropriate treatment (side-effects of medicines) may be causally related to relapse in schizophrenia. However, the possibility that these variables may be caused by relapse or may be explained by a common underlying variable needs to be assessed prospectively. [source] Effects of polydipsia,hyponatremia on seizures in patients with epilepsyPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 3 2007MITSUTOSHI OKAZAKI md Abstract Aggravation of seizures due to hyponatremia was investigated in five patients with epilepsy and polydipsia,hyponatremia. They experienced marked increases in the frequency of their complex partial seizures with a decrease in the serum sodium level to 118,127 mEq/L. In all cases, the serum sodium level returned to normal through restriction of fluids, and the clinical seizures improved. All patients had shown intellectual impairment and/or psychotic episodes, and all had been given antipsychotics. Hyponatremia caused by polydipsia appears to be a risk factor for aggravation of habitual seizures in patients with epilepsy. [source] | ||||||||||||||||||||||||||||