Title: Neuropsychiatric Manifestations of Juvenile Absence Epilepsy as a Diagnostic Challenge
Authors: Ravi L. Maharaj M.B.B.S, Malav Patel M.B.B.S, Luis Rodriguez M.D, Nirmit Gajjar M.B.B.S., Himani J. Suthar M.D, Ellie Rapp B.A., Parinda Parikh M.D.
Volume: 10
Issue: 9
Pages: 110-112
Publication Date: 2026/09/28
Abstract:
Background: Bipolar Disorder is a psychiatric illness characterized by manic or hypomanic episodes. Juvenile Absence Epilepsy is an idiopathic epilepsy syndrome characterized by absence seizures and generalized tonic clonic seizures beginning in adolescence around puberty. Epilepsy can present with behavioral symptoms that resemble psychiatric disorders, creating diagnostic challenges. Case Presentation: We present a 21 year old patient with known Juvenile Absence Epilepsy who developed episodes of erratic behavior and was diagnosed with Bipolar Disorder after an episode associated with stimulant abuse. Lamotrigine was used for seizure control, while psychiatric treatment was initially added for mood symptoms. During elective electroencephalographic monitoring, manic appearing behavior was observed immediately before an absence seizure, establishing a temporal relationship between the behavioral changes and seizure episodes. After seizure treatment was intensified, the mood and behavioral episodes ceased. Discussion and Conclusions: Epilepsy can produce neuropsychiatric changes through effects on brain regions including the prefrontal cortex, limbic system and temporal lobe. From observation alone, it may be difficult to determine whether impaired functioning is psychiatric or neurological. This case highlights the importance of considering epilepsy in the differential diagnosis of abnormal behavior.