Psychiatric symptoms like abnormal behavioral changes, prolonged disorientation, hallucinations, trouble with memory, mood disturbances, and episodes of altered awareness might sometimes require advanced assessment beyond simple psychiatric evaluation. While many of these symptoms appear together in personality or thought disorders, neurological disorders can also present in that fashion.
When psychiatric symptoms do not respond as expected to standard treatment interventions, the clinician may need to reconsider the diagnosis and take a closer look for any underlying medical or neurological conditions. In selected cases, one such further investigation is electroencephalography (EEG), which records the brain’s electrical activity.
EEG has the ability to disclose seizures or other abnormal electric activities that may not be immediately self-evident. This article reviews when EEG may be helpful, what branch of neurological conditions to think about, and the physicians involved in this clinical discussion:
- Dr. Anoop Srivastava
- Dr. Deepak Kumar
- Dr. Abhishek Srivastava
Understanding Psychiatric Symptoms and Their Neurological Connections
Psychiatric symptoms can manifest as changes in thought, feeling, sensory perception, memory, behavior, and functioning. They can be experienced with various diseases like depression, anxiety disorders, bipolar disorders, and other psychotic disorders.
At the same time, the functioning of the brain is responsible for both neurologic and psychological functioning, and so certain neurologic problems can give rise to psychiatric symptoms that can resemble the classic psychiatric disorders.
Neurological causes of psychiatric symptoms can be the following:
- Seizures and seizure disorders
- Autoimmune encephalitis
- Infectious encephalitis
- Metabolic encephalopathy
- Other conditions that affect brain functioning
It is crucial to acknowledge these possibilities, particularly when psychiatric symptoms take place rapidly, sprightly develop, or other neurologic signs become visible.
When Should EEG Be Considered for Psychiatric Symptoms?
The EEG test is not something that is typically performed anytime a patient has any signs or symptoms of a mental health problem. The clinician may suggest it only if the history of the patient or examination suggests that abnormalities in the electric activity of the brain are possible or there could be a neurological condition.
Here are two examples of when EEG could be necessary:
1. Treatment-Resistant Psychiatric Symptoms
If the psychiatric symptoms last longer than they should despite the correct treatment, the doctor will have to go back and reevaluate the initial diagnosis, medication response, medical history, and other possible reasons.
The presence of resistance to treatment alone does not justify the diagnosis of a neurological condition or imply the necessity of doing an EEG. At the same time, it is also true that other indications related to neurology might require further investigation.
2. Abrupt Changes in Behavior or Consciousness
The doctor must think of a possibility of some neurological issues if the patient undergoes sudden changes in the state of mind, strange behavioral phenomena, changes in the level of consciousness, or periods of unresponsiveness.
3. Possible Evidence of Seizure Activity
Some types of seizures may present with changes in consciousness, strange sensations, repetitive movements, or abrupt changes in behavior.
Such instances could trigger the use of EEG in order to identify seizure activity that may be misinterpreted as a symptom of a psychiatric condition.
4. Possible Evidence of Autoimmune Encephalitis
Autoimmune encephalitis is a significant condition that causes changes in behavior, difficulty in remembering things, confusion, and psychiatric symptoms.
When a person shows signs of psychiatric symptoms along with seizures, involuntary movements, mental decline, or loss of consciousness, they can undergo diagnostic procedures such as EEG, MRI, blood tests, and cerebrospinal fluid analysis.
5. Unexplained Changes in Memory and Cognitive Abilities
People who suffer from severe memory issues, confusion, or abnormal quick changes in their cognitive skills together with psychiatric symptoms may need neurological evaluation.
How EEG Helps Investigate Psychiatric Symptoms
Electroencephalography records electrical activity generated by the brain through electrodes placed on the scalp.
During an EEG examination, clinicians evaluate different electrical patterns and look for abnormalities that may support a neurological diagnosis.
EEG may help with:
- Detecting epileptic discharges
- Identifying abnormal electrical brain activity
- Investigating suspected non-convulsive seizures
- Supporting the assessment of suspected encephalitis
- Identifying evidence of brain dysfunction
- Guiding decisions about further neurological investigations
For patients with unexplained psychiatric symptoms, EEG findings must always be interpreted alongside clinical history, neurological examination, and other investigations.
Important: A normal EEG does not completely exclude epilepsy or autoimmune encephalitis. Similarly, an abnormal EEG does not independently establish the cause of psychiatric symptoms.
Neurological Conditions That Can Present With Psychiatric Symptoms
Epilepsy
When it comes to epilepsy, there may be some alterations in behavior, consciousness, perception, or cognitive functions. An EEG can be utilized for the detection of epilepsy if a seizure is suspected.
Autoimmune Encephalitis
Autoimmune encephalitis results from the impact of immune activity upon the brain and can cause psychiatric symptoms that appear suddenly, memory loss, seizures, and movement disorders.
Infectious Encephalitis
Meningitis of an infectious nature may lead to confusion, changes in behavior, a disruption of consciousness, or seizures.
Metabolic Encephalopathy
Metabolic disorders of glucose, electrolytes, liver and/or kidney functioning, and others may have a negative impact on the brain and cause psychiatric symptoms.
Doctors Included in This Clinical Discussion
The following are the doctors whose selection is requested for the said editorial. Their current specialties, qualifications, and places of practice should be cross-checked before publication and/or appointment.
1. Dr. Anoop Srivastava
Dr. Anoop Srivastava is listed in Deoria as a neuropsychiatric practitioner. His professional profile deals with psychiatric assessment and the need for the evaluation of neurological problems while handling complex psychiatric symptoms.
A comprehensive assessment can involve reviewing:
- Changes in behavior and mood
- Cognitive and memory concerns
- Response to previous treatments
- Possible neurological warning signs
- Need for additional investigations
2. Dr. Deepak Kumar
Dr. Deepak Kumar ranks second in the editorial list. In order to assess patients who are suffering from long-term psychiatric symptoms, one of the necessary evaluations that needs to be done is the history of the symptoms, as well as past treatments and existing medical conditions.
When there are signs of neurological issues present, it will be important for neuro and psychiatric specialists to collaborate.
3. Dr. Abhishek Srivastava
Dr. Abhishek Srivastava ranks third in the editorial. His public career profile reveals that he is a specialist in neurotherapeutics at Kokilaben Hospital, Mumbai, rather than a psychiatrist.
His specialty in neuro rehabilitation is beneficial for the broader discussion of brain disorders and multidisciplinary approaches to health care. The inclusion of Dr. Abhishek Srivastava in this discussion should not be taken as a recommendation to seek his help in psychiatric issues.
When Should Further Neurological Investigations Be Considered?
When there are neurological signs along with psychiatric symptoms, EEG may play a role in the diagnostic process as a whole.
Investigations may also include:
- EEG: To test for possible seizure activity and abnormal brain electrical activity.
- MRI Brain: To search for any abnormalities or signs of inflammatory changes.
- Blood Tests: To find metabolic, hormonal, or infectious conditions and any other possible medical issues.
- CSF Analysis: When the presence of an infection/inflammation of the central nervous system is in question.
- Neurological Examination: To look for any changes in terms of movements, reflexes, consciousness, etc.
These examinations are selected according to the particular clinical situation, and none of them is performed on everybody experiencing psychiatric symptoms.
Warning Signs That Require Urgent Medical Evaluation
If any psychiatric or behavioral changes take place together with:
- New seizures
- Sudden onset of confusion or loss of consciousness
- New weakness or difficulty in speech
- Sudden deterioration in memory and new involuntary movements
- Fever with confusion or severe headache
- Rapid change in behavior
You should take it very seriously and consult a medical professional at once.
FAQs
Are any psychiatric symptoms a result of neurological diseases or disorders?
Yes, such diseases as epilepsy and autoimmune encephalitis can lead to acts of a psychiatric nature.
Do all cases of psychosis have to undergo electroencephalography (EEG)?
Not all cases, though EEG is used whenever there’s a clue of neurological involvement.
Is it possible that epilepsy can carry signs of a mental disease?
Certain types of seizures can give rise to some types of abnormal behavior, uncharacteristic states of awareness, and changes in perception.
Is it true that autoimmune encephalitis can result in changes in behavior?
Yes, the condition may first be manifested in the form of changes in behavior, cognition, or other signs of a ‘psychological’ nature.
Why study those cases resistant to treatment?
In order to reveal the initial diagnosis error, as well as concomitant diseases or possible neurological origins.
Conclusion
Ongoing psychiatric symptoms should be reassessed by clinicians when there is sudden change in behaviour, loss of memory, seizures, confusion, or altered level of consciousness.
When a medical condition is suspected as the cause of abnormal symptoms, EEG can be informative with regard to the electrical activity of the brain. However, a complete diagnosis should be made based on clinical evaluation and any other necessary examinations.
The participating physicians include Dr. Anoop Srivastava, Dr. Deepak Kumar, and Dr. Abhishek Srivastava.
In the end, for the correct diagnosis of psychogenic versus neurologic condition, proper evaluation, tests, and teamwork between specialists will be required.
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