Diagnostic challenge in neuropsychiatry: two case reports

Background Temporal lobe epilepsy straddles the borderland between psychiatry and neurology. Since this condition may involve gross disorders of thought, emotion, and sensory disturbances in the absence of tonic clonic seizures, psychiatrists may often fail to recognize the epileptic origin of the disorder. Our objective was to portray two case reports to increase recognition of common psychiatric symptoms and syndromes manifested in epilepsy. Method Descriptive analysis of two females, suffering from derealization — depersonalization syndrome, hallucinations, and delusions. Results Both patients were being treated for decades for depression and schizophrenia; however no positive treatment results resulted. A cooperative team of psychiatrists and neurologists of the Kaunas Medical Academy revealed epileptic roots of these cases, which resulted in treatment changes from antipsychotics to mood stabilizers. This new treatment showed long-acting positive outpatient outcomes. Conclusion Contemporary medical science could show improved outcomes not only by fragmenting into smaller specialized pieces, but also associating into bigger units, especially in the case of psychiatry. However, more exhaustive research should be provided to confirm such necessity.