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.
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.
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.”
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!
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/