A 20 year old female has thoughts of cutting her fingers, and imagines doing it but never actually does it. She says she is not having any guilt of having such thought. And also says the thoughts are distressing her and she is unable to control them. The thoughts vanish either by ending with a seizure or automatically subside on their own. Which of the following is the likely cause?

Focal seizures can present with psychic symptoms without impairment of cognition. These may later progress to generalized seizures, usually of tonic clonic type. Forced thinking is a type of 'psychic symptoms' in which patient feels compelled to think about a specific topic or word again and again. Another psychic symptoms is 'crowding of thoughts' in which patient has a feeling of racing, disorganized thoughts. In this question, the phenomenon described ends with a seizure and is consistent with description of 'forced thinking'