At 50 I was taken to my knees by epilepsy. I have had three invasive brain surgeries since the. 18 months ago I had my Right Temporal Lobe removed, a Lobectomy. I am feeling much better as I recover and my brain rewires itself. Why did I have it removed?
- Personality Changes: Long-term epilepsy, especially originating in the temporal lobe, can sometimes lead to shifts in personality, irritability, or aggression.
- Cognitive Decline: Severe or uncontrolled seizures can lead to permanent changes in brain function, affecting memory, attention, and executive functions like planning and organization.
Causes of These Issues
The link between epilepsy and mental health is multifactorial, involving:
- Neurological Factors: Seizure activity often affects brain regions responsible for emotions, such as the temporal lobe and limbic system.
- Psychosocial Stress: The social stigma, loss of independence (e.g., inability to drive), and constant fear of a public seizure contribute to isolation and emotional distress.
- Medication Side Effects: Some anti-seizure medications (ASMs) can trigger or worsen mood changes, irritability, and suicidal thoughts as a side effect.
What treatments help with depression and anxiety in people with epilepsy?
What types of seizures carry a higher risk of psychosis?
What are the different classifications of epilepsy based on seizure type?
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Psychiatric Comorbidities in People With Epilepsy – PMC – NIH
Abstract * Purpose of Review. To review the latest evidence concerning the epidemiology, clinical implications, and management of …
National Institutes of Health (NIH) | (.gov) -
Epilepsy and Mental Health Explained
The other evidence of the close relationship between mental health and epilepsy is that people who have a history of mood disorder…
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Childhood Epilepsy: Mental Health and Behavior
Related Pages. … Mental health and behavioral problems are among the many issues that can affect children with epilepsy. As with…
What types of seizures carry a higher risk of psychosis?
While various types of epilepsy can lead to psychiatric complications, specific seizure patterns and locations are linked to a significantly higher risk of psychosis. Research in 2024 and 2025 indicates that the risk of psychosis in individuals with epilepsy is roughly
8 times higher than in the general population.
The seizure types and conditions with the highest risk include:
1. Temporal Lobe Epilepsy (TLE)
Temporal Lobe Epilepsy is the form of epilepsy most strongly associated with psychosis.
- Risk Level: Psychotic disorders affect roughly 7% to 11% of those with TLE, compared to about 3% to 5% for other seizure types.
- Location: Seizures originating in the mesial temporal lobe (deep structures like the hippocampus and amygdala) are particularly high-risk due to their role in regulating emotion and perception.
- Symptoms: This can manifest as ictal psychosis (during a seizure) with sudden hallucinations or interictal psychosis (between seizures) resembling chronic schizophrenia.
2. Seizure Clusters and Secondary Generalization
The frequency and intensity of seizures directly impact psychosis risk.
- Postictal Psychosis (PIP): This most commonly occurs following a cluster of seizures or a secondarily generalized tonic-clonic seizure (where a focal seizure spreads to the whole brain).
- Lucid Interval: A unique feature of PIP is a “lucid interval” of 12 to 72 hours where the person appears normal before suddenly developing acute delusions or paranoia.
4. Refractory (Drug-Resistant) Epilepsy
Individuals whose seizures are poorly controlled despite multiple medications are at higher risk. Long-term, active disease (often 15+ years) is a major risk factor for developing chronic “schizophrenia-like” psychosis.
5. Forced Normalization (Alternative Psychosis)
In a paradoxical phenomenon known as forced normalization, some patients develop acute psychosis exactly when their seizures become fully controlled.
- This can occur after a sudden change in medication or successful epilepsy surgery.
- It is theorized that the brain may require a “balance” of electrical activity, and suppressing it too abruptly can trigger psychiatric symptoms.
Summary of Risk Factors (2025-2026 Data)
| Factor | Associated Risk Detail |
|---|---|
| Origin | Temporal lobe (especially left-sided or bilateral) |
| Seizure Type | Focal impaired awareness and secondarily generalized |
| Frequency | Clusters of multiple seizures within a short period |
| Structural | Hippocampal sclerosis or brain lesions (tumors, hamartomas) |
| History | Early age of onset and history of status epilepticus |
