:Temporal Lobe Epilepsy:Is it in your differential diagnosis? Two Case ReportsObjective:Temporal Lobe Epilepsy (TLE), also referred as Complex Partial Seizures, is a medical diagnosis that must be considered in the pediatric, adolescent, and adult population presenting for psychiatric care. Mood disorders are common in people with epilepsy, with a prevalence rate of 20 to 50%. Scant literature exists that seeks specifically to enhance our knowledge of the similarities and subtle differences between TLE, Bipolar Disorder (BD) and Post Traumatic Stress Disorder (PTSD). Our objective is to describe an adolescent and adult case; one initially diagnosed as BD, the other PTSD, when in fact, it was TLE. We aim to illustrate that misdiagnosis and failure to diagnose are common. The provider must engage in a thorough review of systems and consider TLE in the differential diagnosis. A delay in the appropriate diagnosis and treatment can lead to a substantial amount of adverse effects and worsening of symptoms and negatively impact one’s quality of life.Method:Two case studies; an adolescent and one adult, diagnosed with BD and the other PTSD. Both endorsed a history of symptoms indicative of TLE. Key assessment findings and screening diagnostics alerted us to the differential diagnosis of TLE. The overlap of the symptom presentation is described.Results:TLE and many psychiatric conditions often present with overlapping symptoms. Patients have the potential to present with absence seizures, unprovoked irritability, oppositionality, aggression, anger, paroxysmal anxiety, somatic symptoms such as headaches, nausea, burning in the abdomen, stereotyped movements or behaviors, hypergraphia bizarre or incongruous affect, symptoms of fear, disturbed sleep, tearfulness, memory problems, déjà vu, fugue states, changes in cognition, inability to concentrate, fatigue, auditory and visual hallucination and bad temper.Our differential diagnosis of TLE was confirmed with electroencephalogram (EEG). By prescribing the appropriate medications to these two individuals, they were able to experience improved moods, become more productive in society, working, attending church, family outings, etc. They were weaned off their antipsychotic medications, of which an abundance of troubling side effects is now a non-issue.Conclusions:A delay in the proper diagnosis of TLE can have a significant negative impact on the adolescent and adult population. A need exists to educate mental health professionals on the overlap of symptoms of TLE and psychiatric disorders. The significant issue at hand is that they may not be receiving adequate or appropriate medications. Considering TLE in the differential diagnosis of presenting mood instability ensures our patients they are getting the basics of psychiatric care; which always emphasizes ruling out medical conditions first.

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130 颞叶癫痫：在您的鉴别诊断中吗？两例报告

：颞叶癫痫：在您的鉴别诊断中吗？两例报告目标：颞叶癫痫 (TLE)，也称为复杂部分性癫痫发作，是一种医学诊断，在接受精神科护理的儿科、青少年和成人人群中必须考虑。情绪障碍在癫痫患者中很常见，患病率为 20% 至 50%。很少有文献专门寻求增强我们对 TLE、双相情感障碍 (BD) 和创伤后应激障碍 (PTSD) 之间的相似之处和细微差别的了解。我们的目标是描述一个青少年和成人案例；一个最初被诊断为 BD，另一个是 PTSD，而事实上，它是 TLE。我们旨在说明误诊和诊断失败是常见的。提供者必须对系统进行彻底审查，并在鉴别诊断中考虑 TLE。延迟适当的诊断和治疗会导致大量的不良反应和症状恶化，并对一个人的生活质量产生负面影响。方法：两个案例研究；一名青少年和一名成人，被诊断患有 BD 和其他 PTSD。两人都承认有 TLE 症状的病史。关键评估结果和筛查诊断提醒我们注意 TLE 的鉴别诊断。描述了症状表现的重叠。结果：TLE 和许多精神疾病经常出现重叠症状。患者可能会出现失神发作、无端易怒、对抗性、攻击性、愤怒、阵发性焦虑、躯体症状，如头痛、恶心、腹部灼热，刻板的动作或行为，多写 奇怪或不协调的影响，恐惧症状，睡眠障碍，流泪，记忆问题，似曾相识，神游状态，认知变化，无法集中注意力，疲劳，幻听和幻觉和不良脾气。我们对 TLE 的鉴别诊断是通过脑电图 (EEG) 证实的。通过为这两个人开出适当的药物，他们能够体验到改善的情绪，在社会、工作、参加教堂、家庭出游等方面变得更有效率。他们不再使用抗精神病药物，其中有大量令人不安的副作用现在已经不是问题了。结论：延迟正确诊断 TLE 会对青少年和成年人产生重大的负面影响。需要对精神卫生专业人员进行关于 TLE 和精神疾病症状重叠的教育。手头的重要问题是他们可能没有得到足够或适当的药物。在表现情绪不稳定的鉴别诊断中考虑 TLE 可确保我们的患者获得基本的精神科护理；它总是强调首先排除医疗条件。