Adult-onset primary psychosis intersects with lifelong psychosis of epilepsy: A case report

Location

LSUHSC-NO

Publication Date

April 2026

Start Date

9-4-2026 10:00 AM

End Date

9-4-2026 2:00 PM

Description

Temporal lobe epilepsy is known to present with associated psychotic symptoms including olfactory hallucinations and delusions, among others. Postictal psychosis (PIP), ictal psychosis (IP), and forced normalization can all occur with specific types of epilepsy. lnterictal psychosis (IIP) involves a chronic schizophrenia-like state that may develop in patients with longstanding uncontrolled epilepsy, although this is rare and differs from schizophrenia in that it generally lacks severe negative symptoms, has preserved personality, and presents at an older age.

Here, we present a case of first break primary psychosis (suspected to be schizophrenia) in a 29-year-old male who has a history of temporal-lobe epilepsy from childhood onward with associated seizure-related psychotic symptoms. This was a rare and interesting case of a patient with a history of psychosis of epilepsy since childhood who then began as an adult to develop a primary psychosis. New onset symptoms included social withdrawal, visual and auditory hallucinations, delusions, and ideas of reference that began to be present at baseline in between seizure episodes. This case was a lesson in identifying the presentation of new onset primary psychotic symptoms in a patient with a history of secondary psychosis related to a neurologic condition.

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Apr 9th, 10:00 AM Apr 9th, 2:00 PM

Adult-onset primary psychosis intersects with lifelong psychosis of epilepsy: A case report

LSUHSC-NO

Temporal lobe epilepsy is known to present with associated psychotic symptoms including olfactory hallucinations and delusions, among others. Postictal psychosis (PIP), ictal psychosis (IP), and forced normalization can all occur with specific types of epilepsy. lnterictal psychosis (IIP) involves a chronic schizophrenia-like state that may develop in patients with longstanding uncontrolled epilepsy, although this is rare and differs from schizophrenia in that it generally lacks severe negative symptoms, has preserved personality, and presents at an older age.

Here, we present a case of first break primary psychosis (suspected to be schizophrenia) in a 29-year-old male who has a history of temporal-lobe epilepsy from childhood onward with associated seizure-related psychotic symptoms. This was a rare and interesting case of a patient with a history of psychosis of epilepsy since childhood who then began as an adult to develop a primary psychosis. New onset symptoms included social withdrawal, visual and auditory hallucinations, delusions, and ideas of reference that began to be present at baseline in between seizure episodes. This case was a lesson in identifying the presentation of new onset primary psychotic symptoms in a patient with a history of secondary psychosis related to a neurologic condition.