[Forced normalization].

Abstract

Two patients are described who had frequent epileptic seizures, one with primary generalized, the other with partly complex type, in whom after treatment EEG pattern became normal but acute psychotic disturbances appeared. In the literature this phenomenon is known as "forced normalization". The term is not precise since it reduces it to only EEG changes leaving aside seizures and psychosis as alternative of seizures. The condition occurs usually in young persons who previously had no psychotic changes, but had frequent daily seizures, usually generalized of absence type, treated usually with suximide, but in some cases the syndrome was observed in other types of epilepsy treated with other drugs. The incidence of the syndrome is estimated at 1%. Haloperidol is the treatment of choice, but sometimes psychotic episodes were so intense that anticonvulsants had to be withdrawn, as this occurred in one of the reported cases.