Repeated stages of fugue in patients with epilepsy: case series

Objective: To find out prolonged recurrent states of fugue in patients with epilepsy.

Methodology We have included five cases from psychiatry and child guidance OPD, Institute of Medical Sciences, B.H.U., Varanasi. The initial evaluation was done by consultant in-charge psychiatry and CGC OPD. The investigations were sent and finally all patients were referred to neurology OPD and the neurologist made final diagnosis. For further confirmation, CT scan/MRI head and EEG recording of all patient were done.

Results: The age of all five cases varied from 12 to 45 years and out of five, two were females; they belonged to lower socioeconomic status and were educated. Two patients had positive family history of epilepsy but their siblings did not have similar complaints. All five patients have initial agitation followed by wandering aimlessly for varied durations. Findings of CT scan, laboratory investigations were normal but EEG in all five patients was abnormal.

Conclusion: The fugue stages in psychological disorder differ from patients with epilepsy/organic causes of fugue, in dissociative fugue, there are temporal relation found with psychological trauma. In those phases, patient maintains his safety with different identity and the initial symptom of abnormal behavior unlikely occurs. We found in these cases that patients were not able to maintain themselves during fugue stage and their initial presentations were agitation and the important differences were found in EEG reports, those were abnormal.

 

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