Forced normalization: an important phenomenon in the relationship between psychiatric disorders and epilepsy

BAHALI M. K. , ZENGIN M., Tamam L. , Oezpoyraz N., BOZDEMİR H.

KLINIK PSIKOFARMAKOLOJI BULTENI-BULLETIN OF CLINICAL PSYCHOPHARMACOLOGY, cilt.18, sa.4, ss.322-326, 2008 (SCI İndekslerine Giren Dergi) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 18 Konu: 4
  • Basım Tarihi: 2008
  • Sayfa Sayıları: ss.322-326


Although it had long been observed that psychiatric disorders occur in patients with epilepsy, it was only in the 19th century that those were understood and classified. Having been demonstrated in the literature for the last 50 years, forced normalization (alternative psychosis, paradoxical normalization) is a phenomenon that emerges in patients diagnosed with epilepsy. Landolt described it as "a phenomenon characterized by the relative or complete normalization of EEG findings, compared to the previous ones after the occurrence of psychotic states." The psychiatric disorders reported are mostly psychoses, however, "prepsychotic dysphoria" (insomnia, irritability, anxiety), hysteria, and hypochondriasis as well as mood disorders (depression, mania) have also been reported. The pathogenic mechanisms and neurobiological processes that cause this phenomenon have riot yet entirely understood. Moreover, there is lack of information on the incidence of this phenomenon. in this report, the potential pathogenic mechanisms, clinical features, and the diagnosis of forced normalization that is generally assessed by neurologists, yet is also attracting the attention of psychiatrists with the increasing number of cases reported recently, will be reviewed.