Research May Help Clinicians Identify Epilepsy Patients Who Need Closer Follow-up

Some people with epilepsy experience delusions, hallucinations, paranoia and confusion after a seizure. While these episodes usually last only days, a new study led by Carilion researchers and published today in BMJ Neurology Open suggests they may place patients at significantly higher risk of developing psychiatric disorders later.

Varsha Nandwana, MD, a neurologist at CNRV, was the lead author of the study, which examined the relationship between the post-seizure episodes and longer-term mental health disorders. Using information from patients’ medical records, the research team compared the outcomes of patients who experienced temporary psychotic symptoms after a seizure with similar patients who did not. 

"For years, we've known these episodes can happen after a seizure, but we didn't know what they might mean for a person's long-term mental health," said Dr. Nandwana. “Our findings suggest they shouldn't simply be viewed as something that comes and goes. They may identify patients who would benefit from closer follow-up." 

While the study did not confirm that these episodes cause mental illness, the findings show a strong link between the two conditions and could change the way doctors care for patients with epilepsy. Rather than ending treatment once the symptoms disappear, clinicians may consider monitoring patients' mental health more closely in the months and years that follow. Earlier recognition of psychiatric symptoms could lead to earlier treatment and support.

"This study reminds us that epilepsy can affect more than neurological function, it can also affect mental health. By paying attention to these warning signs, we may be able to identify patients who need additional care sooner and perhaps understand the origin of mental illness better," said Aashit Shah, MD, chief of Neurology and collaborator on the study.

Other collaborators include Anita Kablinger, MD, vice chair of research, Psychiatry and Behavioral Medicine, along with faculty members from the University of North Carolina at Chapel Hill; University of Washington School of Medicine and Seattle Children's Hospital.

The study was funded by the Carilion Clinic Department of Medicine.

Read the original study.