Geschwind syndrome

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Geschwind syndrome, also known as Gastaut-Geschwind, is a group of behavioral phenomena evident in some people with temporal lobe epilepsy. It is named for one of the first individuals to categorize the symptoms, Norman Geschwind, who published prolifically on the topic from 1973 to 1984.[1] There is controversy surrounding whether it is a true neuropsychiatric disorder.[2] Temporal lobe epilepsy causes chronic, mild, interictal (i.e. between seizures) changes in personality, which slowly intensify over time.[1] Geschwind syndrome includes five primary changes; hypergraphia, hyperreligiosity, atypical (usually reduced) sexuality, circumstantiality, and intensified mental life.[3] Not all symptoms must be present for a diagnosis.[2]

Only a subset of people with epilepsy in general and temporal lobe epilepsy in particular present with features of Geschwind syndrome[4] and a recent review concluded that the evidence for a link between temporal lobe epilepsy and hyperreligiosity "isn't terribly compelling."[5]

Features

Hypergraphia

Hypergraphia is the tendency for extensive and compulsive writing, and has been observed in Temporal Lobe Epilepsy patients who have had multiple seizures.[6] Those with hypergraphia have extreme attention to detail in their writing. Some patients keep diaries and write down meticulous details about their everyday lives. In certain cases, the writing of patients has demonstrated extreme interest in religious topics. Also, these individuals tend to have poor penmanship. The novelist Fyodor Dostoyevsky showed symptoms of Geschwind syndrome, including hypergraphia.[7]

Hyperreligiosity

Some individuals may exhibit increased, usually intense, religious feelings and philosophical interests,[8] and partial (temporal lobe) epilepsy patients with frequent numinous-like auras have greater ictal and interictal spirituality.[9] Some seizures include ecstatic experiences.[10] It has been reported that many religious leaders exhibit this form of epilepsy.[11][12] These religious feelings can motivate beliefs within any religion, including Voodoo,[13] Christianity, Islam,[14] and others. There are reports of patients converting between religions.[15] A few patients internalize their religious feelings: when asked if they are religious they say they are not.[16]

Atypical sexuality

People with Geschwind syndrome reported higher rates of atypical or altered sexuality.[17] In approximately half of individuals hyposexuality (i.e. decreased libido) is reported.[18][19] Cases of hypersexuality have also been reported.[20]

Circumstantiality

Individuals that demonstrate circumstantiality (or Viscosity) tend to continue conversations for a long time and talk receptively.[21]

See also

References

  1. ↑ 1.0 1.1 Devinsky, J.; Schachter, S. (2009). "Norman Geschwind's contribution to the understanding of behavioral changes in temporal lobe epilepsy: The February 1974 lecture". Epilepsy & Behavior. 15 (4): 417–24. doi:10.1016/j.yebeh.2009.06.006. PMID 19640791.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  2. ↑ 2.0 2.1 Benson, D. F. (1991). "The Geschwind syndrome". Advances in neurology. 55: 411–21. PMID 2003418.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  3. ↑ Tebartz Van Elst, L.; Krishnamoorthy, E. S.; Bäumer, D.; Selai, C.; von Gunten, A.; Gene-Cos, N.; Ebert, D.; Trimble, M. R. (2003). "Psychopathological profile in patients with severe bilateral hippocampal atrophy and temporal lobe epilepsy: Evidence in support of the Geschwind syndrome?". Epilepsy & Behavior. 4 (3): 291–297. doi:10.1016/S1525-5050(03)00084-2.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  4. ↑ Benson, D.F. & Hermann, B.P. (1998) Personality disorders. In J. Engel Jr. & T.A. Pedley (Eds.) Epilepsy: A comprehensive textbook. Vol. II (pp.2065–2070). Philadelphia: Lippincott–Raven.
  5. ↑ Craig Aaen-Stockdale (2012). "Neuroscience for the Soul". The Psychologist. 25 (7): 520–523.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  6. ↑ Tremont, Geoffrey; Smith, Megan M; Bauer, Lyndsey; Alosco, Michael L; Davis, Jennifer D; Blum, Andrew S; LaFrance, W Curt (2012). "Comparison of personality characteristics on the bear-fedio inventory between patients with epilepsy and those with non-epileptic seizures". The Journal of neuropsychiatry and clinical neurosciences. 24 (1): 47–52. doi:10.1176/appi.neuropsych.11020039.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  7. ↑ Hughes, John R (2005). "The idiosyncratic aspects of the epilepsy of Fyodor Dostoevsky". Epilepsy and behavior. 7 (3): 531–8. doi:10.1016/j.yebeh.2005.07.021. PMID 16194626.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  8. ↑ Devinsky, Julie; Schachter, Steven (2009). "Norman Geschwind's contribution to the understanding of behavioral changes in temporal lobe epilepsy: the February 1974 lecture". Epilepsy & behavior. 15 (4): 417–24. doi:10.1016/j.yebeh.2009.06.006. PMID 19640791.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  9. ↑ Dolgoff-Kaspar, R ; et al. (2011). "Numinous-like auras and spirituality in persons with partial seizures". Epilepsia. 52 (3): 640–6. doi:10.1111/j.1528-1167.2010.02957.x. PMID 21395568. Epilepsy patients with frequent numinous-like auras have greater ictal and interictal spirituality of an experiential, personalized, and atypical form, which may be distinct from traditional, culturally based religiosity. Explicit use of et al. in: |first1= (help)<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  10. ↑ Picard, Fabienne; Kurth, Florian (2014). "Ictal alterations of consciousness during ecstatic seizures". Epilepsy & Behavior. 30: 58–61. doi:10.1016/j.yebeh.2013.09.036. PMID 24436968. Patients with ecstatic epileptic seizures report an altered consciousness, which they describe as a sense of heightened perception of themselves - they "feel very present"- and an increased vividness of sensory perceptions. Unknown parameter |laysummary= ignored (help)<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  11. ↑ Muhammed, Louwai (2013). "A retrospective diagnosis of epilepsy in three historical figures: St Paul, Joan of Arc and Socrates". Journal of medical biography. 21 (4): 208–11. doi:10.1177/0967772013479757.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  12. ↑ Nakken, Karl O; Brodtkorb, Eylert (2011). "[Epilepsy and religion]". Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række. 131 (13–14): 1294–7. doi:10.4045/tidsskr.10.1049.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  13. ↑ Carrazana E. ; et al. (1999). "Epilepsy and Religious Experiences: Voodoo Possession". Epilepsia. 40 (2): 239–241. doi:10.1111/j.1528-1157.1999.tb02081.x. Unknown parameter |laysummary= ignored (help); Explicit use of et al. in: |last1= (help)<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  14. ↑ Stephen, M.D. Salloway (1997). "The Neural Substrates of Religious Experience". The Neuropsychiatry of Limbic and Subcortical Disorders. American Psychiatric Publications. ISBN 0880489421.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  15. ↑ Dewhurst, K; Beard, A W (1970). "Sudden religious conversions in temporal lobe epilepsy". The British journal of psychiatry : the journal of mental science. 117 (540): 497–507. doi:10.1192/bjp.117.540.497.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  16. ↑ Waxman, Stephen G, MD; Geschwind, Norman, MD (1972). "The Interictal Behavior Syndrome of Temporal Lobe Epilepsy". Archives of General Psychiatry. 32 (12): 1580–1586. doi:10.1001/archpsyc.1975.01760300118011. PMID 1200777. Unknown parameter |laysummary= ignored (help)<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  17. ↑ Gerhard J. Luef (2008). "Epilepsy and sexuality". Seizure. 17 (2): 127–130. doi:10.1016/j.seizure.2007.11.009. Unknown parameter |laysummary= ignored (help)<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  18. ↑ Harden, Cynthia L (2006). "Sexuality in men and women with epilepsy". CNS spectrums. 11 (8 Suppl 9): 13–8. PMID 16871133.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  19. ↑ L Tebartz van Elsta ; et al. (2003). "Psychopathological profile in patients with severe bilateral hippocampal atrophy and temporal lobe epilepsy: evidence in support of the Geschwind syndrome?". Epilepsy & Behavior. 3 (4): 291–297. doi:10.1016/s1525-5050(03)00084-2. PMID 12791331. Unknown parameter |laysummary= ignored (help); Explicit use of et al. in: |last1= (help)<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  20. ↑ Rees, Peter M; Fowler, Clare J; Maas, Cornelis (2007). "Sexual function in men and women with neurological disorders". Lancet. 369 (9560): 512–25. doi:10.1016/s0140-6736(07)60238-4. PMID 17292771.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
  21. ↑ Devinsky, Orrin; Vorkas, Charles; Barr, William (2006). "Personality disorders in epilepsy". Psychiatric Issues in Epilepsy: A Practical Guide to Diagnosis and Treatment. Lippincott Williams & Wilkins. ISBN 078178591X.<templatestyles src="Module:Citation/CS1/styles.css"></templatestyles>
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