Forced normalization: An overlooked entity in epileptic patients

Topkan A., Bilen S., Titiz A. P., Eruyar E., Ak F.

Asian Journal of Psychiatry, vol.23, pp.93-94, 2016 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 23
  • Publication Date: 2016
  • Doi Number: 10.1016/j.ajp.2016.07.017
  • Journal Name: Asian Journal of Psychiatry
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.93-94
  • Keywords: Epilepsy, Forced normalization, Normal EEG, Psychosis, PSYCHOSIS
  • Lokman Hekim University Affiliated: No


© 2016 Elsevier B.V.The “forced normalization” phenomenon is characterized by acute/subacute onset of psychotic symptoms in the early post-ictal period with dramatic improvement of electrophysiological epileptiform activity. A 56 years old female with going on personality changes, maladaptive behaviours and a mild cognitive impairment since last seizure which was forty-five days ago has been admitted. An evident increase was observed in her maladaptive behaviours with the use of levetiracetam. She began describing visual hallucinations and déjàvu. Control EEG performed 24 h after the seizure was completely normal. Levetiracetam therapy was replaced with phenytoin. Quetiapine therapy was also administered. Psychotic symptoms disappeared.