Epilepsy and verbosity

Epilepsy, language, and social skills

Language and social skills are essential for intrapersonal and interpersonal functioning and quality of life. Since epilepsy impacts these important domains of individuals' functioning, understanding the psychosocial and biological factors involved in the relationship among epilepsy, language, and social skills has important theoretical and clinical implications. This review first describes the psychosocial and biological factors involved in the association between language and social behavior in children and in adults and their relevance for epilepsy. It reviews the findings of studies of social skills and the few studies conducted on the inter-relationship of language and social skills in pediatric and adult epilepsy. The paper concludes with suggested future research and clinical directions that will enhance early identification and treatment of epilepsy patients at risk for impaired language and social skills.

Third International Congress on Epilepsy, Brain, and Mind: Part 2

Epilepsy is both a disease of the brain and the mind. Here, we present the second of two papers with extended summaries of selected presentations of the Third International Congress on Epilepsy, Brain and Mind (April 3-5, 2014; Brno, Czech Republic). Humanistic, biologic, and therapeutic aspects of epilepsy, particularly those related to the mind, were discussed. The extended summaries provide current overviews of epilepsy, cognitive impairment, and treatment, including brain functional connectivity and functional organization; juvenile myoclonic epilepsy; cognitive problems in newly diagnosed epilepsy; SUDEP including studies on prevention and involvement of the serotoninergic system; aggression and antiepileptic drugs; body, mind, and brain, including pain, orientation, the "self-location", Gourmand syndrome, and obesity; euphoria, obsessions, and compulsions; and circumstantiality and psychiatric comorbidities.

Conversational repair in pediatric epilepsy

This study examined if children with complex partial seizures disorder (CPS) and primary generalized epilepsy with absence (PGE) were impaired in the use of self-initiated repair during a conversation compared to normal children. Transcriptions of speech samples of 92 CPS, 51 PGE, and 65 normal children, ages 5-16 years, were coded for self-initiated repair according to Evans (1985). The WISC-R, a structured psychiatric interview, and seizure-related information were obtained for each child. We found impaired use of repair in both the CPS and PGE groups compared to the normal subjects. The CPS patients, particularly those with a temporal lobe focus, overused self-initiated corrections of referents and syntax compared to the PGE and normal subjects. The CPS and PGE patients with frontal lobe involvement underused fillers compared to the normal children. These findings provide additional evidence that both CPS and PGE impact the ongoing development of children's communication skills.

Modification of activation and evaluation properties of narratives by weak complex magnetic field patterns that simulate limbic burst firing

In two separate experiments a total of 71 volunteers were asked to generate spontaneous narratives that were scored automatically by the Whissell Dictionary of Affect. During the narratives, weak (1 microT; 10 mG) magnetic fields were applied briefly through the temporal planes. In Experiment I, subjects who were exposed to simple sine wave or pulsed fields generated more scorable words that indicated lower activation and evaluation than sham-field conditions. In Experiment II subjects exposed to a computer-generated wave form, designed to simulate neuronal burst firing, generated narratives dominated by more pleasantness and less activation than a reference group. The possibility that this approach could be utilized to study the affective dimension of language selection was indicated.

Vectorial cerebral hemisphericity as differential sources for the sensed presence, mystical experiences and religious conversions

Multiple variants of the sensed presence often precede mystical and religious experiences that are frequently followed by sudden, permanent changes in self-concept. The model of vectorial hemisphericity assumes that the relative metabolic activity of synaptic patterns between the cerebral hemispheres at the time of transient interhemispheric intercalation determines the affect, content, and type of experience. Depending upon the relative activity of the two hemispheres, intrusions of the right hemispheric equivalent of the left hemispheric (and linguistic) sense of self generate experimental phenomena that include "evil entities," gods, out-of-body experiences, and alterations in space-time. Conditions that facilitate interhemispheric intercalation and the generation of these experiences are discussed.

A clinical study of hypergraphia in epilepsy

Fifteen patients with epilepsy and hypergraphia were compared with 32 patients with epilepsy but without hypergraphia. The number of previous psychiatric episodes, the number of Washington Psychosocial Seizure Inventory (WPSI) items indicating emotional maladjustment, and the number of CT scan abnormalities were significantly greater in the hypergraphic patients than in the non-hypergraphic patients. Cognitive performance, EEG laterality and the scores of WPSI items related to the psychological stress of seizures did not differ significantly between the two groups. Hypergraphia reflects changes in emotional responsiveness secondary to organic temporal lobe lesions.

Viscosity and social cohesion in temporal lobe epilepsy

Clinical case reports suggest that viscosity, the behavioural tendency to talk repetitively and circumstantially about a restricted range of topics, is common in patients with temporal lobe epilepsy (TLE). Such patients are also reported to exhibit heightened levels of social cohesion, the tendency to become interpersonally "clingy". This "sticky" interpersonal style may be particularly common in TLE patients with a left sided temporal lobe seizure focus. To test this hypothesis, self-report and observer rating scales were developed to assess both viscosity and social cohesion. Subjects consisted of patients with right, left, or bilateral temporal lobe seizure foci, absence or primary generalised tonic-clonic seizures, psychiatric controls (panic disorder patients), and normal controls. Elevations on the viscosity scale were observed primarily in TLE patients with left or bilateral seizure foci. Viscosity scores also correlated with seizure duration and left handedness. No group differences were observed on the social cohesion scale. These findings are consistent with the hypothesis that viscosity results from subtle interictal language disturbances, although other pathogenetic mechanisms are discussed.

Psychopathology in epilepsy: prevalence, phenomenology and management

Epilepsy is associated with interictal behavioral disturbances. The pattern of specific psychopathology differs from that of other chronic diseases because of the higher incidence of psychosis and characterological disorders. Approximately 7 percent of epileptics develop a chronic atypical psychosis with paranoid and affective features, and this may be more common in patients with a definite temporal lobe focus. Brief psychotic episodes occur and are more directly related to cerebral dysrhythmia. A subgroup of epileptics develop specific personality traits, aggressive behaviors under certain circumstances, and hyposexuality. Affective illness and suicide are also prevalent. There are special issues in the management of psychopathology in the setting of epilepsy such as the relative seizure threshold lowering effects of psychotropic drugs and the behavioral effects of altering the seizure control. This article discusses both diagnostic and management aspects of the interictal psychopathology of epilepsy.