Platinum Global Journal of Medicine and Medical Sciences (PGJMMS) Vol. 1(2) pp. 007-013, April, 2015 Available online http://platinumglobaljournals.org/pgjmms/index.php Copyright © 2015 Platinum Global Journals Full Length Research Paper Prevalence and characteristics of psychotic episodes in patients with resistant and well-controlled epileptic seizures Georgi Panov 1 , Ivan Milanov 2 and Iliyana Pacheva 3 * 1 Multiprofile University Hospital for Active Treatment “Stoian Kirkovich”, Stara Zagora 2 Multiprofile University Hospital for Treatment in Neurology and Psychiatry “St. Naum”, Sofia 3 Department of Pediatrics and Medical Genetics, Medical University-Plovdiv, Bulgaria Accepted 18 February, 2015 The relation between epilepsy and schizophrenic psychosis has been the focus of interest for many psychiatrists. To investigate the prevalence and the particular characteristics of psychotic episodes in patients with refractory and well-controlled epileptic seizures. We studied 139 patients with epilepsy, aged 18-70, for a period of 5 years. Ninty three of the patients were with well-controlled seizures and the remaining 46 patients had therapy-resistant seizures. Patients with either severe debilitating central nervous system diseases, or severe somatic diseases, or mental disabilities were excluded. Eight individuals (5.75% of all patients with epilepsy) had psychotic episodes. Psychotic episodes were registered in 5(10.86%) of the patients with therapy-resistant seizures, compared to 3 (3.23%) in well- controlled group. In the therapy-resistant patients we revealed earlier onset of the disease, a longer period of time between the psychotic episodes and the debut of epilepsy, than in well controlled group, and also the presence of polymorphic seizures, mainly complex partial seizures, and apparent changes in their electroencephalogram (EEG). The increased incidence of psychotic episodes in patients with resistant seizures is probably related to the progress of the disease and the consequent neural and biological changes. The presence of psychotic episodes is more typical for patients with refractory epileptic seizures. The psychotic episodes in such patients occur late after the onset of epilepsy, which usually has its debut at an early age. Keywords: Epilepsy, psychotic episodes, refractory seizures, EEG INTRODUCTION The relation between epilepsy and schizophrenic psychosis has been the focus of interest for many psychiatrists ever since 19 century (Hill (1953), Pond (1957)). Hill (1953) and Pond (1957) suggested an *Corresponding Author E-mail: inapatcheva@hotmail.com increased incidence of psychosis in patients with temporal lobe epilepsy, as well as several years of distance between the onset of the disease and the first psychotic episode. In the 1950s Landault (1958) introduced the currently well-known concept of the relation between forced normalization of EEG and the occurrence of epileptic psychoses. He postulated the reverse relation between the abnormal psychiatric