SPECT findings during postictal psychoses: Predominance of relative increase of perfusion in right temporal lobe

To identify brain regions activated during episodes of postictal psychoses (PIP), we investigated single‐photon emission computed tomography (SPECT) data obtained from five patients treated at our institutions and also reviewed four previous studies. Therefore, SPECT findings in a total of 19 cases were analyzed, including 16 patients with temporal lobe epilepsy (TLE). During nonpsychotic states, the laterality of epileptic foci was judged as left‐sided in nine episodes, right‐sided in six episodes, and nonlateralized in four episodes. In PIP states, 88% of the patients showed a relative increase of right temporal perfusion (increased right temporal or decreased left temporal perfusion). Regardless of whether right‐ or left‐sided pathology was suspected during a nonpsychotic state, SPECT findings obtained during PIP episodes revealed a trend of right‐sided temporal predominance.