Monday, September 30, 2013

The Obsessive Neurotic

One  of the  most striking  descriptions  of  personally  in neurology  is in  patients  with epilepsy  that arises  from the  temporal  lobes.  The temporal lobes are located on either side of the brain roughly in the area beneath the ears and are the seat of human memory and emotion.  It has been shown  in a number  of studies  that disturbances  in this region  can  result  in striking  behavioral  or cognitive  (memory attention etc) change.

An American neurologist Noramal Geschwind, widely  regard  as the  father of  behavioral  neurology  described  specific  personality  features  in people  with temporal   lobe  epilepsy  These  includes :-

A tendency  to write  copiously  (but not  necessarily  in a creative  way)  and to     keep  voluminous  diaries  (hypergraphia )

A tendency to be overly religious, often in a ritualistic manner, out of keeping with the person’s family/ cultural background (Hyper- religiosity). 
           
A tendency to have a decreased interest in sexual matters (hypo-sexuality).

A tendency  for anxiety  and obsessionality  to dwell  on minor  matters  and to  experience  difficulty  in terminating social intercourse  (emotional  viscosity  or stickiness).

An increased interested in spiritual or ideational issues in the absence of pragmatic interests.
            
Turbulent emotions- irritability, agitation, anxiety,   restlessness, paranoia etc. 
           
 Mood swing commonly spells of depression with occasional elation.    
           
 Psychotic and quasi psychotic phenomena, transient hallucinations, delusional thinking   
 etc.  Occurring on and off.
           
These personality  traits  have been  described  mainly  in people  with chronic  temporal  lobe  epilepsy  that failed  to respond  to anti-epileptic  drug therapy.  We must  remember  the vast  majority  of people  with temporal lobe  epilepsy are honest,  conscientious,  sincere  and upright  members  of the community  they live  in, these positive  qualities being  aided  perhaps  by the  personality  traits  described. Only  in a small  proportion  of people,  usually  those  with severe epilepsy  do these  traits  become  severe  and/ or  disabling  in some  way therefore  these are  probably  the behavioral  manifestations  of the  pathology  in the brain  that  most  often  underlies  temporal  lobe  epilepsy,  sclerosis  of a part  of the  temporal  lobe called  the hippocampus

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