# A Complex Presentation: Psychosis in a Patient Diagnosed With Lennox-Gastaut Syndrome

## TL;DR

A 19-year-old with Lennox-Gastaut syndrome, a severe form of epilepsy, developed rare psychotic symptoms like hallucinations and self-harm.

## Contribution

Highlights a rare clinical presentation of psychosis in a patient with Lennox-Gastaut syndrome.

## Key findings

- The patient exhibited multiple breakthrough seizures and significant neurocognitive disabilities.
- Psychotic features such as auditory hallucinations and self-mutilation were observed.
- This case emphasizes the complexity of managing psychiatric comorbidities in LGS.

## Abstract

Lennox-Gastaut syndrome (LGS) is a form of severe childhood epilepsy, with most children experiencing seizures before reaching the age of eight. Typically, patients have multiple types of seizures, making an accurate diagnosis challenging. While it can be secondary to other causes, often, it is idiopathic. Over time, children develop cognitive impairment, leading to intellectual disability. The mainstay of treatment and management is seizure control. However, management remains challenging due to the complexity of the syndrome, as it is associated with multiple seizure types, intellectual deterioration, and other psychiatric comorbidities. We present the case of a 19-year-old male diagnosed with LGS and treated with various available therapies, who demonstrated multiple breakthrough seizures, significant neurocognitive disabilities, and behavior challenges. Additionally, the patient displayed psychotic features of auditory hallucinations, aggression, and attempts at self-mutilation, a rare clinical presentation in LGS.