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Published Online:https://doi.org/10.1176/ajp.96.3.595

The literature on psychoses associated with epilepsy has been reviewed. Twenty-two personal cases are described. Fourteen had clouded states, which were found to be transitory obscurings of consciousness of varying depths, developing some years after seizures first began, usually occurring after several successive convulsions, characterized nearly always by overactivity, by variable speech abnormalities, wide variations of mood, visual and auditory hallucinations, delusions, disorientation, poor recent memory, defective judgment, and little or no insight. In some cases, the content of the psychosis could be partly traced to earlier factors in the patient's lives. The clouded states were compared to alcoholic pathological intoxication. Three had chronic psychoses resembling schizophrenia. One other was considerably deteriorated. The rest were unclassified. The neuropathological processes underlying these conditions are unknown. The clouded states contribute to the study of psychopathology. Psychotherapy might be of some value. There is great need of research in this almost untouched field.

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