Geschwind syndrome

Geschwind Syndrome, also known as Gastaut-Geschwind, is a group of behavioral phenomena evident in some temporal lobe epilepsy patients. 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 sexuality, circumstantiality, and intensified mental life.[3] Not all symptoms must be present for a diagnosis.[2]

Only a subset of patients 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. 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. Fyodor Dostoyevsky, a famous writer, has shown symptoms of Geschwind syndrome including hypergraphia.

Hyperreligiosity

Some individuals may exhibit increased, usually intense, religious feelings. It has been reported that many religious leaders exhibit this form of epilepsy. These religious feelings can be expressed in multiple different religions. There are reports of patients that move from religion to religion for multiple different reasons. Some patients internalize their religious feelings: when asked if they are religious they say they are not.

A recent review concluded that the evidence for a link between temporal lobe epilepsy and hyperreligiosity "isn't terribly compelling."[5]

Atypical Sexuality

Geschwind patients reported higher rates of atypical or altered sexuality. In approximately half of individuals hyposexuality (i.e. decreased libido) is reported. Cases of hypersexuality have also been reported.

Circumstantiality

Individuals that demonstrate circumstantiality tend to continue conversations for a long time and talk receptively.

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.
  2. ↑ 2.0 2.1 Benson, D. F. (1991). "The Geschwind syndrome". Advances in neurology 55: 411–21. PMID 2003418.
  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. doi:10.1016/S1525-5050(03)00084-2.
  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. ↑ 5.0 5.1 Craig Aaen-Stockdale (2012). "Neuroscience for the Soul". The Psychologist 25 (7): 520–523.