Phenytoin Augmentation of Levetiracetam Treatment: A Case of Forced Normalization With Emergence of Psychosis

Forced normalization is the emergence of psychoses following stabilization of seizures in an uncontrolled epileptic patient. The current study is a case of forced normalization, a phenomenon characterized by normalization of electroencephalogram (EEG) findings and resolution of seizures. This case r...

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Bibliographic Details
Published in:	Curēus (Palo Alto, CA) Vol. 10; no. 4; p. e2432
Main Authors:	Esang, Michael, Kotapati, Vijaya Padma, Ahmed, Saeed
Format:	Journal Article
Language:	English
Published:	United States Cureus Inc 05-04-2018 Cureus
Subjects:	Anticonvulsants Case reports Epilepsy Family/General Practice Neurology Patients Psychiatry Psychosis United States > US forced normalization anticonvulsant epilepsy seizures seizure control convulsions seizure disorder antiepileptic (aed)-induced psychotic disorder (aipd) psychoses phenytoin kindling levetiracetam
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Summary:	Forced normalization is the emergence of psychoses following stabilization of seizures in an uncontrolled epileptic patient. The current study is a case of forced normalization, a phenomenon characterized by normalization of electroencephalogram (EEG) findings and resolution of seizures. This case report is unique and rare because the patient meets the diagnostic merit of forced normalization, which occurred due to a nonconventional method of seizure control management. We discuss the recognition and differential diagnoses of such cases, understanding the phenomenon of forced normalization and treatment strategies, which may help clinicians in their clinical practice.
ISSN:	2168-8184 2168-8184
DOI:	10.7759/cureus.2432