The symptoms of psychosis were unlikely to be postictal
psychosis for two reasons: first, in four patients
the onset of symptoms was rather slow and evolved
over 1–2 weeks, and secondly, there was no history
of a seizure for at least three weeks before the onset
of psychotic symptoms in three patients. One patient
never had any seizures while on topiramate therapy and
one other patient had only one complex partial seizure
during 18 days of topiramate treatment. Complex partial
status epilepticus was not a consideration based on
clinical examinations. Two patients had normal EEGs
at the time of symptoms.