Forced normalization and psychosis following use of lacosamide Karine Abou Khaled, Jean Khoury, Gabrielle Macaron, Sami Richa  Seizure - European Journal of Epilepsy  Volume 41, Pages 96-99 (October 2016) DOI: 10.1016/j.seizure.2016.07.011 Copyright © 2016 British Epilepsy Association Terms and Conditions

Fig. 1 (a) EEG done in 2012 (electrodes placed according to the 10–20 international system, in addition to inferior temporal electrodes) showing diffuse interictal background slowing, irregular high amplitude diffuse sharp delta waves and bilateral fronto-temporal independent spikes during wakefulness. (b) Routine EEG in April 2014 before lacosamide administration showing left temporal delta slowing with bitemporal spikes in addition to spikes and waves over the left fronto-temporal region with rare fragments of relatively normal background (c) EEG done in September 2014 (5 months after lacosamide), revealing much improved background. There was 8Hz posterior dominant rhythm during wakefulness with diffuse theta waves and very rare sharp waves and slowing over the left temporal region. Episodes of visual hallucinations and delusions were recorded and had no EEG correlate. In the sample image patient is fighting an imaginary person. Seizure - European Journal of Epilepsy 2016 41, 96-99DOI: (10.1016/j.seizure.2016.07.011) Copyright © 2016 British Epilepsy Association Terms and Conditions

Fig. 2 Brain CT showing the partially calcified suprasellar process with bilateral frontal and temporal white matter changes more prominent over the left in addition to diffuse atrophy, mild ventriculomegaly and bilateral diffuse calcifications (subcortical regions, basal ganglia, de nucleus and pons). Seizure - European Journal of Epilepsy 2016 41, 96-99DOI: (10.1016/j.seizure.2016.07.011) Copyright © 2016 British Epilepsy Association Terms and Conditions