Delusional Pregnancy in a Patient with Epilepsy: A Case Report

Abstract

Interictal psychosis is a psychotic symptom that is not temporally related to epileptic seizures. Pregnancy delusion is defined as a person's fixed belief that she is pregnant despite objective evidence that she is not pregnant. In this case report, pregnancy delusion was described in a patient with epilepsy. A 31-year-old woman with epilepsy was admitted to a psychiatric ward. The patient, whose pregnancy test results were never positive, believed that she was pregnant. It was learned that her identical twin had experienced reproductive-sexuality-themed psychotic symptoms 10 years ago. The patient was hospitalized for three weeks and discharged in remission with paliperidone 6 mg/day and biperiden 2 mg/day. Caution should be exercised when using antipsychotics because of their epileptogenic effects. Pregnancy delusion in epilepsy is rare. In addition to this rare condition, it is noteworthy that reproductive-sexual delusions were reported in the patient's twin brother who was diagnosed with epilepsy.

Keywords

• Pseudocyesis
• epilepsy
• psychosis

Epilepsi Tanılı Hastada Gebelik Sanrısı: Bir Olgu Sunumu

Abstract

İnteriktal psikoz, epileptik nöbetlerle zamansal olarak ilişkili olmayan psikotik bir semptomdur. Gebelik sanrısı, bir kişinin hamile olmadığına dair nesnel kanıtlara rağmen hamile olduğuna dair sabit inancı olarak tanımlanır. Bu vaka raporunda, epilepsili bir hastada gebelik sanrısı tanımlanmıştır. Otuz bir yaşında epilepsi hastası bir kadın psikiyatri servisine yatırılmıştır. Gebelik test sonuçları hiçbir zaman pozitif çıkmayan hasta gebe olduğuna inanıyordu. Hastanın tek yumurta ikizinin 10 yıl önce üreme-cinsellik temalı psikotik belirtiler yaşadığı öğrenildi. Üç hafta hastanede yatan hasta paliperidon 6 mg/gün ve biperiden 2 mg/gün tedavisiyle remisyonla taburcu edilmiştir. Epileptojenik etkileri nedeniyle antipsikotik kullanırken dikkatli olunmalıdır. Epilepside gebelik sanrısı nadirdir. Bu nadir duruma ek olarak, hastanın epilepsi tanısı almış ikiz kardeşinde de üreme-cinsel sanrıların bildirilmiş olması dikkat çekicidir.

Keywords

• Yalancı gebelik
• epilepsi
• psikoz

References

1. Swinkels WA, Kuyk J, van Dyck R, Spinhoven P. Psychiatric comorbidity in epilepsy. Epilepsy Behav. 2005;7(1):37-50.
2. Irwin LG, Fortune DG. Risk factors for psychosis secondary to temporal lobe epilepsy: a systematic review. J Neuropsychiatry Clin Neurosci. 2014;26(1):5-23.
3. Clancy MJ, Clarke MC, Connor DJ, Cannon M, Cotter DR. The prevalence of psychosis in epilepsy; a systematic review and meta-analysis. BMC Psychiatry. 2014;14:75.
4. Bahali MK, Zengin M, Tamam L, Ozpoyraz N, Bozdemir H. Forced normalization: an important phenomenon in the relationship between psychiatric disorders and epilepsy. Psychiatry Clin Psychopharmacol. 2008;18(4):322-6.
5. Sachdev P. Schizophrenia-like psychosis and epilepsy: the status of the association. Am J Psychiatry. 1998;155(3):325-36.
6. Tascon-Cervera JJ, Crisostomo-Siverio AI, Cardenes-Moreno C, Dorta-Gonzalez JF, Morera-Fumero AL. Psychosis in epilepsy vs late-onset schizophrenia: a case report. Cureus. 2022;14(12):e32692.
7. Ray M, Kumar S, Sinha A, Pisharody RR. Delusion of pregnancy: conception in brain. Ind Psychiatry J. 2022;31(2):341-5.
8. Bera SC, Sarkar S. Delusion of pregnancy: a systematic review of 84 cases in the literature. Indian J Psychol Med. 2015;37(2):131-7.

9. Gurgu RS, Ciobanu AM, Danasel RI, Panea CA. Psychiatric comorbidities in adult patients with epilepsy (A systematic review). Exp Ther Med. 2021;22(2):909.
10. Adachi N, Kanemoto K, de Toffol B, Akanuma N, Oshima T, Mohan A, et al. Basic treatment principles for psychotic disorders in patients with epilepsy. Epilepsia. 2013;54(Suppl 1):19-33.
11. Adachi N, Akanuma N, Ito M, Okazaki M, Kato M, Onuma T. Interictal psychotic episodes in epilepsy: duration and associated clinical factors. Epilepsia. 2012;53(6):1088-94.
12. Henning O, Nakken KO. Epilepsirelaterte psykoser [Epilepsy-related psychoses]. Tidsskr Nor Laegeforen. 2013;133(11):1205-9. Norwegian.
13. Seeman MV. Pseudocyesis, delusional pregnancy, and psychosis: the birth of a delusion. World J Clin Cases. 2014;2(8):338-44.
14. Paholpak P, Gan JJ, Mendez MF. Neuropsychiatric aspects of epilepsy. In: Sadock BJ, Sadock VA, Ruiz P, editors. Kaplan and Sadock's comprehensive textbook of psychiatry. 10th ed. Philadelphia: Wolters Kluwer; 2017. p.517.
15. Nagdive AB, Bhainsora RS, Fernandes R, Behere PB, Sethi S. Pseudocyesis leading to folie-à-deux. J Neurosci Rural Pract. 2021;12(2):419-23.