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Introduction: Epilepsy and psychosis are not only closely related by clinical phenomena but presumably by causal factors, too. There is evidence that long-standing epileptic seizures can induce chronic psychosis. Whether chronic psychosis can cause epilepsy remains to be further investigated., Case Report: We report a case of a 28-year-old man with chronic psychosis since early childhood who developed epilepsy many years after the onset of the psychosis. Medical treatment resulted in complete remission of psychosis and seizures., Conclusion: 1.) This case could be a further example for the bidirectional causality of psychosis and epilepsy. 2.) A conditioning psychosis could be understood as a variety of interictal psychosis and complement current classifications., Competing Interests: Die Autoren geben an, dass kein Interessenskonflikt besteht., (© Georg Thieme Verlag KG Stuttgart · New York.)

Taking care of dying people is one of the most difficult obligations of the physician, especially if these patients are suffering from dementia and accordingly when their current capacity to consent is arguable. In this field, numerous ethical and forensic problems arise that have to be considered. Legal medical end-of-life decisions that potentially shorten life (Sterbehilfe) are divided into two categories: direct "Sterbehilfe" refers to stopping life-prolonging measures. Indirect "Sterbehilfe" describes the use of agents to alleviate symptoms of a terminally ill patient which may however, shorten life expectancy. A physician terminating a patient's life based on his own decision and authority of action always acts illegally. This paper describes the current discussion on this issue in Germany considering the medical and legal aspects of it while focussing on patients suffering from dementia and their ability to form and to articulate their own will., (© Georg Thieme Verlag KG Stuttgart · New York.)

Introduction: Hashimoto encephalopathy is a rare disease that is associated with Hashimoto thyreoiditis. Dementia, disturbances of consciousness and epileptic seizures are the most common features., Case Report: We report a case of Hashimoto encephalopathy in a 74-year-old woman who presented with psychotic episodes, visual hallucinations, dementia, tremor, rigidity and fluctuation of consciousness. After treatment with steroids, cognitive function became normal and other symptoms improved significantly., Conclusion: Hashimoto encephalopathy should be considered as a differential diagnosis of psychosis in combination with dementia and other neurological symptoms to dementia with Lewy bodies and Creutzfeldt-Jakob disease.

The classic literature on pathological laughter and crying emphasizes the difference between incontinence and lability of affect. Pathological laughter and crying as key symptoms of affect incontinence are viewed as the effects of disinhibition of motor synergisms without congruent affect, which is the crucial difference to affect lability. The interpretation as a disinhibitory phenomenon is supported by clinical and electromyographic observations, which found a lack of modulation of intensity in pathological laughter and crying. In 1924, Wilson postulated a supranuclear pontobulbar center for affective synergisms that is controlled by cortex and thalamus. Accordingly, Kleist viewed a combined lesion of thalamic or brainstem structures and corticofugal motor projection systems as the pathoanatomic basis of affect incontinence. Recent work reported the frequent occurrence of affect incontinence with stroke and dementia of the Alzheimer type and thus disagrees with the classical theory. However, the methods used cannot rule out a confounding between affect lability and incontinence.