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Forced normalization: An overlooked entity in epileptic patients

2016; Elsevier BV; Volume: 23; Linguagem: Inglês

10.1016/j.ajp.2016.07.017

1876-2026

Tuğberk Andaç Topkan, Şule Bilen, Ayşe Pınar Titiz, Esra Eruyar, Fikri Ak,

Pharmacological Effects and Toxicity Studies

The "forced normalization" phenomenon is characterized by acute/subacute onset of psychotic symptoms in the early post-ictal period with dramatic improvement of electrophysiological epileptiform activity. A 56 years old female with going on personality changes, maladaptive behaviours and a mild cognitive impairment since last seizure which was forty-five days ago has been admitted. An evident increase was observed in her maladaptive behaviours with the use of levetiracetam. She began describing visual hallucinations and déjàvu. Control EEG performed 24 h after the seizure was completely normal. Levetiracetam therapy was replaced with phenytoin. Quetiapine therapy was also administered. Psychotic symptoms disappeared.