Exploring the Complexities of an Intricate Connection: Psychosis in Focal Epilepsy: Case Report

Background: Epilepsy is still a real mental health problem; although most epilepsies are curable, their psychopathological consequences are often significant and complex to manage. In this framework, the association of epilepsy with psychotic disorders has long been known. Case Report: To discuss the links between epilepsy and psychosis, we report the observation of a 42-year-old man, treated for complex focal epilepsy, admitted to a psychiatric department for attempting suicide by phlebotomy in a postictal psychosis under the commands of auditory hallucinations and a severe state of psychomotor agitation. Discussion: Psychotic symptoms in epilepsy can be part of intercritical, post-critical or alternative psychoses. In our patient's case, the psychotic symptoms were post-critical. Delusional themes are often mystical, fueled by auditory and unusual visual hallucinations. Negative disorders are rare. Conclusion: Epileptic psychoses have not been identified as nosographic entities in the psychiatric classification systems (DSM-V and ICD-10), which poses a problem in recognizing these disorders. Therefore, a collaboration between psychiatrists and neurologists is necessary to understand this complex comorbidity better, avoid diagnostic errors, and optimize management.