Utilizzo dell’elettroencefalografia nelle psicosi oggi

Introduction

The use of electroencephalography (EEG) in Psychiatry has decreased substantially in recent decades. To identify settings in which this type of testing is still considered useful, we conducted a critical analysis of the current literature on the use of standard EEG in the diagnosis and treatment of psychoses.

Materials and methods

The PubMed and Medline databases were searched for articles published since 2000, using the following keywords

“EEG”, “schizophrenia”, “psychosis”, “clozapine”, “olanzapine”, “risperidone”, “quetiapine”, “antipsychotics”, “street drugs”, and “aggression”.

Results

The review shows that EEG can be useful (and sometimes essential) in the differential diagnosis of an initial psychotic episode and ruling out organic conditions with psychotic symptoms (e.g., psychoses induced by street drugs, alcohol, encephalitis and other brain infections, meningiomas and other brain tumors, ictal or postictal psychoses in epilepsy, forced normalization, and delirium). To different extents, typical and atypical antipsychotics both seem to lower the seizure threshold, and this can lead to abnormalities on standard EEG. These effects are particularly common in patients treated with clozapine. In terms of prognosis, the presence of EEG anomalies before treatment seems to be predictive of poorer responses.

Conclusions

Standard EEG is not widely used in patients with psychoses, but in certain cases it can be in the diagnosis of these disorders and in assessments of prognosis.