Periodic Left Temporal Sharp Waves During Acute Psychosis

This 29-year-old woman with a history of major depression and poorly controlled complex partial and secondarily generalized seizures presented with disorientation, agitation, and hyperreligiosity after six generalized convulsive seizures. During psychosis, electroencephalography revealed waxing and waning periodic sharp waves over the left temporal region, which disappeared after the resolution of psychosis. Prior to and after psychosis, synchronous frontal spike and waves and sharp waves, and intermittent, synchronous high voltage rhythmic and polymorphic frontal slowing were present. This case demonstrates periodic temporal sharp waves that are associated with acute psychosis and topographically distinct from the patient’s interictal abnormalities.