B.A. Kazakovtsev MENTAL DISORDERS IN EPILEPSY Moscow 2015 UDC 616.89 Reviewers: R.G. Golodets, Doctor of Medicine, professor A.L. Maksutova, Doctor of Medicine B.A. Kazakovtsev. <...> Structural and dynamic analysis of the major clinical manifestations of the disease (features of personality changes, paroxysmal disorders, psychotic symptoms, dementia) held in accordance with the main patterns of development of the disease, its types and stages. <...> Place of nonpsychotic mental disorders in the clinical picture of epilepsy .106 4.2. <...> The clinico-pathopsychological criteria of structure and dynamics of epileptic dementia .112 4.3. <...> Structure and dynamics of mental disorders in patients with transitory form of epileptic psychosis 130 4.3.1. <...> Transitory psychoses with the predominantly affective disorders .131 4.3.2. <...> Transitory psychoses with the predominantly delusional disorders.135 4.3.3. <...> Transitory psychoses with the predominantly catatonic disorders.137 4.3.4. <...> Structure and dynamics of mental disorders in patients with schubweise form of the epileptic psychosis .144 4.4.1. <...> Structure and dynamics of mental disorders in patients with chronic fl ow of epileptic psychosis .162 4.5.1. <...> Affective-delusional syndromes with the hallucinatory disorders .169 4.5.4. <...> Affective-delusional syndromes with the catatonic disorders .171 4.5.5. <...> The conducted research showed that the structure of epileptic psychosis is determined by predominance in clinical picture of one of the basic productive psychopathological syndromes: affective, delusional and catatonic. <...> These data suggests that the structure and syndromokinesis of productive and negative psychopathological disorders, as well as the main types of fl ow of the disease are related to the primary lesion considered as functional systems of mediobasal temporal lobe, temporal and frontal lobes of the brain as a whole. <...> Although attempts to classify epileptic psychosis and dementia undertaken since 1838 (E. Esquirol), to date no comprehensive systematic description of their various manifestations. <...> The continuing tendency in the world literature of developing mostly the neurologic rather than the psychiatric divisions of the clinical picture of epilepsy prevents this need. <...> Experience shows that if such an approach can be justifi ed and even necessary in the initial stages of the disease, then with the complexity of the clinical picture, due to its progressive course, multiple psychiatric disorders have to be analyzed with it. <...> However, the tendency of many neurologists and psychiatrists to evaluate psychotic manifestations with epilepsy as comparatively rare and therefore 7 alien to this illness <...>
Mental_Disorders_in_Epilepsy.pdf
UDC 616.89
Reviewers:
R.G. Golodets, Doctor of Medicine, professor
A.L. Maksutova, Doctor of Medicine
B.A. Kazakovtsev.
Mental disorders in epilepsy. M., Prometheus publishing house, 398 p.
The monograph shows the opportunity to study the pathogenesis
of mental disorders in epilepsy based on the characteristics of its fl ow
using clinical methods, structural dynamic, epidemiological and statistical
analysis. Structural and dynamic analysis of the major clinical
manifestations of the disease (features of personality changes,
paroxysmal disorders, psychotic symptoms, dementia) held in accordance
with the main patterns of development of the disease, its types
and stages. On the basis of the multi-axial classifi cation of epilepsy
was developed a model that allows in a retrospective analysis of anamnestic
data and clinical assessment to establish clinical and social
criteria for prognosis prediction.
ISBN 978-5-7042-2538-6
© B.A. Kazakovtsev 2015.
© Prometheus publishing house 2015.
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CONTENTS
Preface ...................................................................................................5
Introduction ...........................................................................................7
Chapter 1. The evolution of the views on the importance of mental
disorders in epilepsy for clinical and social prognosis ...10
Chapter 2. Epidemiology of mental disorders of epilepsy ................32
Chapter 3. Etiology and the pathogenesis ........................................60
Chapter 4. Clinic of mental disorders of epilepsy ...........................102
4.1. Place of nonpsychotic mental disorders in the clinical
picture of epilepsy .......................................................106
4.2. The clinico-pathopsychological criteria of structure
and dynamics of epileptic dementia ..........................112
4.3. Structure and dynamics of mental disorders in
patients with transitory form of epileptic psychosis 130
4.3.1. Transitory psychoses with the predominantly
affective disorders ....................................................131
4.3.2. Transitory psychoses with the predominantly
delusional disorders.................................................135
4.3.3. Transitory psychoses with the predominantly
catatonic disorders...................................................137
4.3.4. Structure and the duration of remissions ..............141
4.4. Structure and dynamics of mental disorders in patients
with schubweise form of the epileptic psychosis ........144
4.4.1. Affective psychoses ..................................................147
4.4.2. Affective-delusional psychoses ................................148
4.4.3. Delusional psychoses ...............................................152
4.4.4. Affective-delusional psychoses with catatonic
inclusions .................................................................155
4.4.5. Catatono-delusional psychoses ...............................156
4.4.6. Catatonic psychoses.................................................157
4.4.7. Structure and duration of remissions ....................158
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4.5. Structure and dynamics of mental disorders
in patients with chronic fl ow of epileptic psychosis ..162
4.5.1. Affective-delusional syndromes with over-valuable
delusion ....................................................................165
4.5.2. Affective-delusional syndromes with a tendency
for systematization of delusions .............................168
4.5.3. Affective-delusional syndromes with the
hallucinatory disorders ...........................................169
4.5.4. Affective-delusional syndromes with the catatonic
disorders ...................................................................171
4.5.5. Catatonic syndromes with the affective-delusional
inclusions .................................................................173
4.5.6. Structure of the personal changes ..........................175
Chapter 5. Differential diagnosis ....................................................178
Glossary of mental disorders in epilepsy .....................197
Criteria of the diagnosis ................................................207
Chapter 6. Possibilities of the combined therapy ...........................228
Chapter 7. Clinical and psycho-social criteria for prognosis .........257
Chapter 8. Prevention and organization of medical, psychological
and social support of patients with epilepsy ................320
Conclusion .........................................................................................351
References .........................................................................................366
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