Case report: Epilepsy surgical outcome for epileptic and non epileptic seizures with posttraumatic stress disorder and depression

Abstract

A 48-year-old male was diagnosed with both drug resistant epilepsy and psychogenic nonepileptic seizures. Both diagnoses were confirmed by video-EEG monitoring. His epileptic seizures were a consequence of right mesial temporal sclerosis. He was diagnosed by a psychiatrist to have depression and posttraumatic stress disorder (PTSD). Following a right anterior temporal resection he became seizure free (both epileptic and nonepileptic) with a remarkable improvement in his psychiatric comorbidities leading to significant reduction in his psychotropic medications. No reports have been identified in the literature of patients with epilepsy and PNES with coexisting PTSD having epilepsy surgery.

Fig. 1

An interictal EEG sample showing 2 examples of interictal right anterior temporal spikes (see arrows).

Fig. 2

Coronal MRI brain samples of the patient with T2 (a) and T2 Flair (b) demonstrated right mesial temporal sclerosis.

Fig. 3

Two consecutive epochs of EEG showing the onset and the evolution of the right temporal ictal rhythm at the onset of one of the patient's recorded epileptic seizures.