Forced normalization: a case report and literature review
10.3760/cma.j.cn113694-20241018-00678
- VernacularTitle:强制正常化1例报道并文献回顾
- Author:
Yujuan HAN
1
;
Xianglong SHI
;
Mengmeng WU
;
Xinyuan MIAO
;
Zhen SUN
;
Yanping SUN
Author Information
1. 青岛大学附属医院神经内科，青岛 266003
- Publication Type:Journal Article
- Keywords:
Epilepsy;
Psychiatric and behavioral abnormalities;
Forced normalization
- From:
Chinese Journal of Neurology
2025;58(7):794-798
- CountryChina
- Language:Chinese
-
Abstract:
Forced normalization (FN) is a rare epileptic psychiatric disorder that usually characterized by the disappearance of seizures and acute psychosis in patients with paradoxical normalization of the electroencephalogram following a change in the dose of antiseizure medication (ASM) or the initiation of a new medication. This article reports a case of a young female patient with Lennox-Gastaut syndrome who developed FN twice after a change in the ASM regimen, which improved after ASM reduction and olanzapine treatment. Further literature review summarizing the clinical features of FN found that there were slightly more females than males in patients with FN, the onset was more common in young adults, and most patients had refractory epilepsy. The psychiatric and behavioral abnormalities included delusions, hallucinations, bizarre behavior, mania, depression, and dissociation. The changes in ASM were the main inducing factor. Most patients improved by adjusting ASM or adding antipsychotic drugs. By reviewing this case, this article aims to increase awareness of the clinical features, characteristics of mental behavioral abnormalities, treatment and prognosis of FN and to improve the clinical management of the disease.
