Schizophrenia and Temporal Lobe Epilepsy

I want to begin by quoting two websites on the symptoms of each. First the Mayo Clinic on the symptoms of schizophrenia and then Richard Restak’s excellent article on TLE.

 

Schizophrenia Symptoms

By Mayo Clinic staff

In general, schizophrenia symptoms include:

* Beliefs not based on reality (delusions), such as the belief that there’s a conspiracy against you

* Seeing or hearing things that don’t exist (hallucinations), especially voices

* Incoherent speech

* Neglect of personal hygiene

* Lack of emotions

* Emotions inappropriate to the situation

* Angry outbursts

* Catatonic behavior

* A persistent feeling of being watched

* Trouble functioning at school and work

* Social isolation

* Clumsy, uncoordinated movements

In addition to the general schizophrenia symptoms, symptoms are often categorized in three ways to help with diagnosis and treatment:

Negative signs and symptoms

Negative signs and symptoms represent a loss or decrease in emotions or behavioral abilities. They may include:

* Loss of interest in everyday activities

* Appearing to lack emotion

* Reduced ability to plan or carry out activities

* Neglecting hygiene

* Social withdrawal

* Loss of motivation

Positive signs and symptoms

Positive signs and symptoms are unusual thoughts and perceptions that often involve a loss of contact with reality. These symptoms may come and go. They may include:

* Hallucinations, or sensing things that aren’t real. In schizophrenia, hearing voices is a common hallucination. These voices may seem to give you instructions on how to act, and they sometimes may include harming others.

* Delusions, or beliefs that have no basis in reality. For example, you may believe that the television is directing your behavior or that outside forces are controlling your thoughts.

* Thought disorders, or difficulty speaking and organizing thoughts, such as stopping in midsentence or jumbling together meaningless words, sometimes known as “word salad.”

* Movement disorders, such as repeating movements, clumsiness or involuntary movements.

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Cognitive symptoms involve problems with memory and attention. These symptoms may be the most disabling in schizophrenia because they interfere with the ability to perform routine daily tasks. They include:

* Problems making sense of information

* Difficulty paying attention

* Memory problems

Complex Partial Seizures Present Diagnostic Challenge

Quotes from Richard Restak’s article in Psychiatric Times (Sept 1,1995)

Since the condition [Temporal Lobe Epilepsy] may involve gross disorders of thought and emotion, patients… frequently come to the attention of psychiatrists. But since symptoms may occur in the absence of generalized grand mal seizures, physicians may often fail to recognize the epileptic origin of the disorder.

In most instances, the emotion experienced as part of the seizure is a disturbing one variously described as dread or a feeling of impending doom; in others, the emotion may be experienced as pleasant or euphoric…Descriptions such as “a wave,” “something flowing upward” are often employed.

Controversy continues as to the validity of a so-called temporal lobe personality… Outbursts of irritability, rather than frank violence, are hallmarks of TLE.

[R]are presentations include anorexia nervosa (Signer and Benson 1990), multiple personality (Schenk and Bear.

Most common is a global hyposexuality (deficit of desire and feeling]…

TLE also may be responsible for chronic rather than just acute psychoses. While any of the symptoms of schizophrenia may be encountered, paranoid traits are the most common. TLE patients can be distinguished from schizophrenic patients by the maintenance, when not acutely ill, of warm affect and good rapport…

The treatment of TLE is complicated by the fact that many times improved seizure control via anticonvulsants leads to deterioration of the neuropsychiatric status. Schizophrenia-like epileptic psychoses often emerge when anticonvulsants are normalizing or improving the seizure activity…

While the illness is an epileptic one and treated by neurologists, many neurologists remain unfamiliar with and even uninterested in its neuropsychiatric components. But by ignoring the experiential symptoms, the neurologist deprives the patient of the opportunity to coherently integrate all aspects of the epilepsy. It may also cement the patient’s misconception that in addition to the epilepsy, he or she suffers from a “mental illness.”

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I was going to go into a deeper discussion of this, but cannot at this hour (11:15pm as I must go to bed now. But I plan if I can to do so tomorrow. And if not then, well, then ASAP. Meanwhile, I would have told my schizophrenia.com readers to think back on all that I’d written over the years, and tell ME what is going on…but you cannot do that, not knowing me as well as all that. Needless to say, however, I do think there is reason to suspect that the second diagnosis might have some possible validity, though it is hard to see how all of my symptoms can have been only TLE…But wow, would I be relieved to have a name for it if they were!

TTFN

There is an interesting discussion about schizophrenia and TLE etc here: Schizophrenia and spiritual experiences: Is there a link? http://livewithwonder.wordpress.com/2011/10/19/schizophrenia-and-spiritual-experiences-is-there-a-link/

11 thoughts on “Schizophrenia and Temporal Lobe Epilepsy”

  1. I’ve been having grand mal seizures for about 20 years. About 1 1/2 yrs ago, I was put on a new medication called Vimpat. It seems to work great until I ran out of them. I was under a lot of stress at the time, and ended up having a grand mal seizure. My husband and my son both say that right after my body seizes up, I get up and start screaming, hitting, biting, etc, trying to get away from something. I never remember anything that happens. My husband tells me it can last anywhere from 15 min., to 45 min. I’m don’t know anything during that period, but I have trouble with my mind. I can’t explain it to anyone, no one would understand my thoughts. Anyone out there willing to help? 😕

  2. Very timely & interesting article,,,
    I thought I was the only one who was losing his mind to Epilepsy & seizure medications.
    Thanks for re-assuring my suspicions that “Something is terribly wrong”.
    Lately, I was wondering if my Epilepsy & seizure medications is leading me to mental (psychological) disorder.
    Now, I see why I’m feeling totally different than the man I’ve known for most of my life.

    Regards,
    Gerrie
    http://www.myspace.com/myseizures

  3. My 14 year old daughter is showing signs of TLE but know doctor has diagnosed it. She just spent 2 1/2 weeks in an adolescent psychiatric ward and is home showing the same signs as before. In a month we will go to Stanford for her 3rd eeg. What antipsychotic do you recommend. She is currently on depakote and seraquel with 50 mg of zoloft. She often says, “I don’t know who I am, and I don’t beleive in God when she does.

  4. I have TLE from childhood, now I have 28 tears old. A pair of months ago I went to a neurologist because I have severe problems when sleeping (I couldn’t rest really). The neurologist ordered an electroencephalogram with an hyperventilation test and the epilepsy appeared as bursts in the EEG. I started to treat the epilepsy using an anticonvulsionant (lamotrigine) and a new “emotional world” appeared to me when contacting people (I had social phobia, paranoid ideation and lack of emotions when contacting people before the treatment), specially the gaze of people started to produce emotions on me… but severe positive schizophrenia symptoms appeared in the following days (negative symproms dissapeared and positive symptoms appeared). I am using now lamotrigine and quetiapine (an antipsychotic to treat schizophernia sumptoms) and I feel really well at this time. An anticonvulsionant + atypical antipsychotic therapy seems to be a good option in TLE cases… at least it work fine for me.

  5. Thanks, this helped a bunch.
    I have severe TLE and have had temporary psychosis in the postictal phase for just about every seizure. In the past 5 years, the psychosis was growing in frequency and intensity due to clusters of seizures. I thought (and was told) that postictal psychosis was a simple label and that was that. But I was slowly unplugging from reality and staying unplugged for months. Then I went to a few Neuro Psych Docs that showed me that I don’t have a “reality” cohering to a social norm on any given day — seizure or not. A pretty good narrative would be “a flow of undiagnosed manic-type experiences and behaviors that turned into reoccurring Psychosis with TLE seizures.”
    The main point being that i had to have a predisposition to the mania for the seizures to bring on manic-psychosis. I thing neuroscience will eventually figure out these “predispositions” but many Docs labeled me to what they were researching at the time. Mainly because so many of these mental conditions overlap.

  6. Some articles I’d never come across. Thank you.
    I’ve started a blog that I should probably keep to myself because someone will send the men in white coats after me (but my neurologists will head them off). I’ve known for sure about my TLE since 1983 and been treated for it. I’ve not been diagnosed schizophrenic, but I am Bipolar. So things are just too complicated for me or my doctors to sort out. Add to that the common TLE symptom of hypergraphia (which, in my writing, demonstrates how religiously “transfixed” I can be — and, well, I’m an interesting suspect at the very least. Keep writing!

  7. Hi. I am currently researching the story on Annelise Michel, a young woman from Germany around 1960’s who was ‘possessed’. However, she was diagnosed with Grand Mal Epilepsy and mild Skitzophrenia, Depression etc. The main symptoms of Grand Mal include urinating, screaming, seizure of limbs etc, halluciantions, smells etc. My question is, is another common symptom of Grand Mal and/or Skitzophrenia seeing or hallucinating of Demonic or Satanic grimaces? Do most or alot of sufferers of these illnesses experience hallucinations like that of religious ones? (Eg; adverse reactions to religious items (rosaries, crucifixes etc), and speaking in a language never learnt (Latin etc). Because with Anneliese, her family and her were deeply religious, so Possession was the main explaination of her behaviours. But, so many of her symptoms were that of Grand Mal and/or Skitzophrenia.

    Thanks

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