ABSTRACT
This chapter considers the extent to which the evidence supports the more speculative hypothesis that the specific pathological processes underlying epileptic seizures are closely related to the pathological processes that generate psychiatric symptoms. Electroencephalographic records of paroxysmal fluctuations in electrical potential between electrodes attached to the scalp during a seizure justify the pathophysiological description of an epileptic seizure as an abnormal electrical discharge of neurons which spreads through the brain. The neurophysiological processes associated with sleep are closely related to the manifestation of paroxysmal electrical activity and to disturbances of affect. The epidemiological studies reviewed demonstrate that between a quarter and a half of those with epilepsy have substantial psychiatric disorder. Depression, anxiety, and suicide are all more common in epileptic patients than in the general population. Sexual dysfunction, especially hyposexuality, is more common in those with temporal lobe epilepsy than in the general population.
