ABSTRACT
This chapter presents a case of a 27-year-old man who is affected with epilepsy has a history of complex partial seizures. He has simple auditory hallucinations during the aura, but also psychotic symptoms between seizures. Prior to being on antipsychotic medication, after the seizures he would typically have a day when he felt well, and then would become unwell with auditory hallucinations, persecutory delusions, low mood and irritability. Extrapyramidal and other side effects can be unpleasant or distressing and may put patients off treatment that in other ways is working well for them. They may rarely be life threatening, especially if the dystonia affects muscles related to breathing. Rarely, withdrawal dyskinesia may occur when medication is stopped. Options for dealing with extrapyramidal side effects include reducing the dose, using more recently developed antipsychotic medication. In some instances a trial without neuroleptics is appropriate, especially if there has been good seizure control in the absence of psychotic experiences.
