Wahid Bakhsh Sajid, Shahid Rasheed.
Temporal lobe Epilepsy (Complex Partial Seizures) a diagnostic dilemma.
J Rawal Med Coll Jan ;9(1):33-5.

A twenty-six-year old farmer developed symptoms following high grade fever which lasted for five days. He started hearing voices of people talking about him. He became suspicious believing that the people had turned against him and wanted to kill him. These symptoms lasted for about a week and remitted spontaneously. He remained symptom-free for a year and then suddenly developed pressure over head, fear of dying and restlessness followed by numbness of the whole body. He repeatedly asked for mercy from his father and then recited Saif-Ul-Maluk for a while. The whole episode lasted for ten minutes. A week later he went to his farm in an elated mood and danced there for twenty minutes. In the mean time, he became fearful and thought that the people around him were all demons who had attacked the world. He was taken to his pir but during the journey he had pressure over head followed by loss of consciousness, for about fifteen minutes. When he regained conciousness, he found himself with his pir who was beating him with a stick. After that he remained mute for four days. At night he saw dreadful images, was terrified and would run away to his pir. He was taken to a psychiatrist who prescribed him antipsychotics as a case of schizophrenia, which he took regularly for 9 months but his condition never improved. On his next visit, he was seen by another psychiatrist who diagnosed him as a case of temporal lobe epilepsy. He started on carbamazepine 200mg twice daily. With treatment, the frequency of seizures decreased to once in 2 months leading to marked improvement of patient`s mood and quality of life.

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