Personality Features It is no secret that psychological characteristics personalities influence emotional condition person, and the latter plays an important role in the occurrence of arterial hypotension. It has been noticed that people often complain of symptoms of hypotension

Hazelnuts with honey to increase immunity after an illness, rheumatism, epilepsy You will need: Honey - 3 tsp. Hazelnuts - 45 g. What to do: Eat 15 g of hazelnuts and 1 tsp. honey daily, three times a day after

It has now been proven that epileptic seizures can occur in people of any age, from all social classes and at any intellectual level, and that epilepsy is often not a disease, much less mental illness in the usual sense of the word.

In the vast majority of cases, epileptic seizures can be controlled with medication, and sometimes they go away on their own.

People with epilepsy are practically no different from people without seizures. In an environment of emotional support from other people, they live normal, fulfilling lives. Despite this, problems may arise for the person with epileptic seizures and their family.

Personality problems:

Decreased level of self-esteem;

Depression;

Difficulties in finding one's place in society;

The need to come to terms with the diagnosis of epilepsy;

Possibility of appearance side effects drug treatment and complications of attacks.

Family problems:

Rejection by family members of the diagnosis of epilepsy;

The need for long-term emotional and material support for a person with seizures;

The need to try not to constantly think about the illness of a loved one;

The need to take reasonable precautions and avoid overprotection;

The need for genetic counseling;

The need to help a person with epilepsy live a full life outside the family;

Need to take into account age characteristics the psyche of a person with seizures;

The opportunity to have your own family and child;

The presence of side effects of drug therapy during pregnancy (danger of fetal hypoxia);

The risk of maternal seizures affecting the normal development of the fetus.

Problems between man and society:

Restrictions on certain types of work;

Discrimination in training and employment;

Limitation of certain forms of leisure and sports;

The need for self-control when drinking alcohol;

Prohibition of driving a car (you can drive a car if you have not had seizures for more than two years);

The need to overcome prejudice in society towards epilepsy and, especially, the idea of ​​epilepsy as a mental illness. People with epilepsy and their families should have time to talk with each other about epilepsy, their problems, experiences and interests.

Epilepsy is not a mental illness!

Epilepsy is sometimes called a mental illness. This concept in relation to epilepsy should be avoided, as it is erroneous and causes prejudice among people.

Epilepsy is not a mental illness.

Mental illnesses include depression, psychosis with hallucinations and mania, as well as diseases accompanied by decreased intelligence and personality changes. Some patients with epilepsy experience periodic psychosis, but this should be considered as a temporary complication. A decrease in intelligence may also occur, but the cause is often not epilepsy, but an underlying brain disease.

People with epilepsy without additional causes, such as brain atrophy, are no more likely to have mental problems than other people. This applies to both children and adults. First of all, among these problems are the delay mental development and behavioral disorders. Such people must be aware that they may be different from those around them, that they are somewhat different.

Unfortunately, sometimes these people see alienation and ridicule from those around them, which aggravates their condition. If epilepsy is not based on brain pathology, patients have normal intelligence. If epilepsy is a consequence of severe brain pathology (trauma, atrophy, etc.), then it is the brain disease, and not the epilepsy itself, that contributes to a decrease in the patient’s intelligence. It has been proven that the attacks themselves, with sufficient treatment, do not lead to a decrease in intelligence. Problems with the risk of mental changes in a person with epilepsy are another argument for more early treatment attacks in order to reduce subsequent social difficulties as much as possible.

Personality disorder

People with epilepsy are usually attributed certain character traits. There is an opinion that these patients are slow, inactive, petty, distrustful and inflexible. Others claim that they are very frivolous, fickle, absent-minded and irresponsible. These opinions arose from individual observations of patients with epilepsy and contain unacceptable generalizations. There is no evidence that the personality traits described above are observed only in people with epileptic seizures. Therefore there are no distinctive features character of such people. However, one should not forget that long-term treatment anticonvulsants (barbiturates, benzodiazepines) could certainly have contributed to a change in character to a slower one with impaired concentration and memory, the appearance of irritability and fussiness.

It is possible that repeated attacks with falls and head injuries can lead to organic changes in the brain and a certain lethargy and slowness. It follows that treatment of attacks should begin as early as possible, since this gives a chance to stop them in early stage diseases. In addition, therapy should be carried out optimal quantity drugs, preferably with one drug and in minimal effective doses.

Personality disorders are the most common symptom of mental disorders found in people with epilepsy, and they appear most often in people with epileptic focus in the temporal lobe.

In general, these violations include:

Age-related desire disorders;

Changes in sexual behavior;

A feature commonly referred to as "viscosity";

Increased religiosity and emotional sensitivity.

Personality disorders in their entirety are rarely pronounced, even in those people who suffer from complex partial seizures caused by damage to the temporal lobe. Most people with epilepsy do not have a personality disorder, but some do have disorders that are very different from the personality changes described below.

It is possible that of these personality traits, the most difficult to describe is viscosity and rigidity. This personality trait turns out to be so typical that it is most noticeable in a conversation, which is usually slow, serious, boring, pedantic, oversaturated with details at the expense of unimportant details and circumstances. The listener begins to get bored, is afraid that the speaker will never get to the right question, wants to get away from this conversation, but the speaker does not give him the opportunity to carefully and successfully extricate himself. This is where the term “viscosity” comes from. The same feature is found in a person with epilepsy when writing and drawing, and hypergraphia is considered by some as a cardinal manifestation of this syndrome. The tendency toward verbosity, circumstance, and excess that is evident in conversation is reflected in the writing of these people. Some people with epilepsy can improve their communication style if a sympathetic listener points out their weaknesses. However, many people lack criticism for their violations, or they do not perceive them as violations. The religiosity of people with epilepsy is often surprising and can manifest itself not only in external religious activity, but also in an unusual preoccupation with moral and ethical issues, reflection on what is good and what is bad, and an increased interest in global and philosophical problems.

Change in sexual vision

Changes in sexual behavior can be expressed in the form of hypersexuality, disturbances sexual relations, for example, fetishism, transvestism and hyposexuality. Quite rare in epilepsy are increased sexual need - hypersexuality and disturbances in sexual relations. Cases of change in sexual orientation—homosexuality—are somewhat more common.

Hyposexuality is much more common and manifests itself both in a general decrease in interest in sexual issues and in a decrease in sexual activity. People whose complex partial seizures began before puberty, may not achieve normal levels of sexuality. Hyposexuality can lead to strong emotional distress and difficulties in starting a family. Unilateral temporal lobectomy, which is sometimes successful in stopping seizures, can have a surprisingly strong positive effect on increasing libido. This operation, however, is rarely used. In addition, if hyposexuality is present, it should be taken into account that one of the main reasons for it may be anticonvulsants (barbiturates, benzodiazepines, etc.) taken for a long time. However, in people with epilepsy, as in other people, the cause of sexual dysfunction should be sought primarily in conflict situations with a partner.

Limitation of independence

Whether a person with epilepsy achieves independence or loses it depends not only on the form of epilepsy and its treatment, but mainly on his self-adaptation. At frequent attacks Loved ones, out of fear of injury, will limit the person's mobility and avoid additional risk factors, such as cycling or swimming. The fear is based on the fact that without supervision and care, an attack will occur, and there will be no one to help him. This gives rise, of course, with the best intentions, to an often exaggerated desire for the constant presence of an accompanying person. These concerns must be countered by the fact that most people with epilepsy are not exposed to trauma. It would also be necessary to weigh whether permanent care actually reduces the risk of deterioration of the condition of a person with epilepsy, or whether it itself brings more harm. It is doubtful that witnessing a seizure can prevent an accident. Often there is not enough strength to catch or hold a person in an attack. It is important that society is as informed as possible about the existence of people with epileptic seizures. This will help people become more compassionate and skilled in providing first aid during attacks.

The downside of constant guardianship is a person’s weakening sense of responsibility for himself. The awareness of constant supervision and the presence of another person reduces a person with epilepsy’s sense of responsibility for their actions, independence in decision-making and their correct assessment. Own experience, even if wrong, strengthens the feeling of self-confidence.

Therefore, you need to come to a compromise between fear for your condition and a certain freedom. It is impossible to find a rule for all occasions. Therefore, in each specific case, it would be necessary to determine, in a conversation with a doctor, the restrictions characteristic of this person with epilepsy.

Dementia (intellectual disability)

Epileptic dementia is characterized by a combination of intellectual failure (decreased level of generalization, lack of understanding of figurative and hidden meaning, etc.) with peculiar personality changes in the form of extreme egocentrism, pronounced inertia, stiffness of mental processes, affective viscosity, i.e. a tendency to long-term fixation on emotionally charged, especially negative experiences, a combination of rancor, vindictiveness and cruelty towards peers and younger children with exaggerated servility, flattery, servility towards adults, especially doctors, medical personnel, teachers. Intellectual deficiency and low productivity in mental work are significantly enhanced by bradyphrenia, the difficulty of engaging in any new activity, switching from one activity to another, excessive thoroughness of thinking with “getting stuck” on little things, which even in the case of a shallow defect in abstract thinking create the impression of an inability to highlight the main ones, essential features objects and phenomena, as a rule, mechanical memory suffers, but events that affect the patient’s personal interests are remembered better. Children with epileptic dementia are often characterized by a gloomy mood background, a tendency to outbursts of affect and aggression when dissatisfied with something. In preschool and younger children school age in behavior, motor disinhibition often comes to the fore, combined with the “heaviness” and angularity of individual movements. Relatively often, including in preschool children, severe disinhibition is observed sexual desire, manifested in persistent and undisguised masturbation, the desire to cling to someone’s naked body, hug, squeeze children. A sadistic perversion of sexual desire is possible, in which children take pleasure in causing pain (biting, pinching, scratching, etc.) to others. When a malignant ongoing epileptic process occurs in early age in the structure of dementia, as a rule, there is a pronounced oligophrenia-like component, and the depth of dementia itself may correspond to imbecility and even idiocy. Distinguishing such an oligophrenia-like variant of epileptic dementia from oligophrenic dementia is possible only by analyzing the entire clinical picture(including epileptic paroxysms) and the course of the disease. More or less typical epileptic dementia described above is present at the onset of the disease in children over 3-5 years of age.

The psychotic state occurs more often in the interictal period, but personality disorders are observed even more often in the interictal state. Psychoses that resemble schizophrenia have been described, and there is evidence that psychoses are more often observed in individuals with temporal lobe epilepsy than in epilepsy without a local focus or with a focus located outside the temporal lobe. These chronic schizophrenia-like psychoses can manifest acutely, subacutely, or have a gradual onset. They usually occur only in patients who have suffered for many years from complex partial seizures, the source of which is disturbances in the temporal lobe. Thus, the duration of epilepsy becomes an important causative factor in psychosis. The onset of psychosis is often preceded by personality changes. Most frequent symptoms Such psychoses are paranoid delusions and hallucinations (especially auditory hallucinations) with clear consciousness. Emotional flattening may occur, but patients often retain emotional warmth and adequate affective experiences. Although a typical feature schizophrenic psychoses are disturbances of thinking; with the organic type of disturbances of thinking, disturbances such as insufficiency of generalizations or thoroughness predominate. The nature of the connection between such psychoses and attacks often remains unclear; in some patients, exacerbation of psychosis is observed when the attacks are successfully stopped, but such a perverted nature of the connection between these phenomena is not necessary. Responses to treatment with antipsychotics are unpredictable. In most patients, these psychoses differ from classical schizophrenic psychoses in several ways. important aspects. The affect is less pronounced, and the personality suffers less than in chronic schizophrenia. Some data indicate the enormous importance organic factors in the occurrence of such psychoses. They occur, as a rule, only in those patients who have suffered from epilepsy for many years, and are much more common in epilepsy with a dominant focus in the temporal lobe, especially if the epileptic focus includes the deep temporal structures of the dominant (usually left) hemisphere. Over time, these people begin to look much more like patients with organic damage brain than in patients chronic schizophrenia, i.e., their cognitive impairments predominate over thinking disorders. Affective psychoses or mood disorders, such as depression or manic-depressive illness, are not observed as often as schizophrenia-like psychoses. In contrast, however, affective psychoses occur episodically and are more common when the epileptic focus is in the temporal lobe of the non-dominant cerebral hemisphere. ABOUT important role Mood disorders in epilepsy can be judged based on the large number of suicide attempts in people with epilepsy.

Depression

May occur in people with epileptic seizures due to:

Excessive concern about their unusual condition;

Hypochondria;

Excessive sensitivity.

It is necessary to distinguish between simple (reactive) depression and depression as an independent disease: reactive depression- this is a reaction to circumstances; depression as a disease is depression associated with individual characteristics, endogenous depression.

Causes of depression in people with epileptic seizures:

Diagnosis of epilepsy;

Social, family, emotional problems associated with epilepsy;

Prodromal symptoms of a depressive nature before an attack (aura in the form of depression);

Depression accompanying an attack;

Depression after an attack;

Persistent depression for a long period after the attack.

Aggression

Aggressive behavior generally occurs with equal frequency in people with epilepsy and in the general population. People with epilepsy are just as capable of violence as others. Sometimes these patients are attributed increased irritability. Although quite often you can meet people without epilepsy who are quite cocky. And for people with epilepsy with their difficult life situation, with scant social contacts, loneliness, restrictions, and also deeply offended by others, with their prejudice and ignorance, it is understandable that sometimes they can be irritable and angry with the whole world.

In addition, a person with epileptic seizures may have additional reasons to become aggressive:

If you force him or hold him during an attack; as a result negative attitude to this person from the side of society;

In the pre-attack or post-attack period;

During an attack of ambulatory automatism or during an aura;

When brain function is impaired after severe attacks leading to personality changes, or mental illness; when he has a negative attitude towards treatment.

Pseudo-seizures

These conditions are intentionally caused by a person and look like seizures. They may appear to attract additional attention or to avoid some activity. It is often difficult to distinguish a true epileptic seizure from a pseudoseizure.

Pseudo-attacks occur:

More common in women than men;

People who have relatives with mental illness in their family;

In some forms of hysteria; in families where there are difficulties in relationships;

For women with problems in the sexual area;

In people with a burdened neurological history.

Clinical manifestations of pseudo-attacks:

Behavior during an attack is simple and stereotypical;

The movements are asymmetrical;

Excessive grimacing;

Trembling instead of convulsions;

Sometimes there may be shortness of breath;

Emotional explosion, state of panic;

Sometimes screaming; complaints of headache, nausea, abdominal pain, redness of the face.

But unlike epileptic seizures, pseudoseizures do not have a characteristic post-seizure phase, a very rapid return to normal state, the person smiles often, there is rarely damage to the body, there is rarely irritability, there is rarely more than one attack in a short period of time. Electroencephalography (EEG) is the main examination method used to identify pseudoseizures.

This disease affects not only the health of the patient, but also his character, behavior and habits. For development mental disorders and personality traits of epileptics are influenced not only by the disease, but also social factors, as well as society, which usually tries to avoid such patients.

Impact on character

Pathological excitation of the cerebral cortex and seizures do not go away without leaving a trace. As a result, the patient's psyche changes. Of course, the degree of mental change largely depends on the personality of the patient, the duration and severity of the disease. Basically, there is a slowdown in mental processes, primarily thinking and affects. As the disease progresses, changes in thinking progress; the patient often cannot separate the important from the unimportant. Thinking becomes unproductive, has a concrete-descriptive, stereotyped character; Standard expressions predominate in speech. Many researchers characterize it as “labyrinthine thinking.”

According to observational data, according to the frequency of occurrence among patients, character changes in epileptics can be arranged in the following order;

• slowness,
• viscosity of thinking,
• heaviness,
• hot temper,
• selfishness,
• rancor,
• thoroughness,
• hypochondriacity,
• quarrelsomeness,

• accuracy and pedantry.

The appearance of a patient with epilepsy is characteristic. Slowness, restraint in gestures, taciturnity, sluggish facial expressions, lack of expression on the face are striking; you can often notice a “steel” shine in the eyes (Chizh’s symptom).

Malignant forms ultimately lead to epileptic dementia. In patients with dementia, it manifests itself as lethargy, passivity, indifference, and resignation to the disease. Sticky thinking is unproductive, memory is reduced, vocabulary is poor. The affect of tension is lost, but obsequiousness, flattery, and hypocrisy remain. The result is indifference to everything except one’s own health, petty interests, and egocentrism.

Social influence

The peculiarities of the manifestation of epilepsy complicate the adaptation of a person, especially a small one, to society. Children often develop reactive states and neuroses due to the disdainful perception of others. To make contact with peers, a child can behave obsequiously and adapt to other children. Due to inertia, such behavior is fixed. Often, when pursuing a goal, patients with epilepsy get stuck at a certain stage due to the inability to distinguish between the main and the secondary.

The formation of vicious character traits could be prevented with a competent attitude of society towards epileptic seizures and timely psychotherapeutic assistance to patients with epilepsy. After all, despite possible changes character, in fact, is not a mental illness. A bunch of famous people suffered from epilepsy, but this did not stop them from leading a full life and leaving their mark on history.

The following basic rules of behavior must be observed:

• Visit your doctor regularly and follow his instructions exactly.
• Keeping a detailed calendar of attacks is especially important for providing assistance during an attack.
• Regular appointments anticonvulsants without self-will and independence. It is strictly prohibited to take other medications or treatments without consulting your doctor. Monitoring side effects of medications.
• Strict adherence to sleep and rest schedules.
• Don't drink alcohol.
• Avoid bright flickering light.
• Do not drive vehicles until the attacks have completely stopped and have been absent for more than two years.

In fact, this problem is quite relevant in psychiatry, neurosurgery and neurology. different countries peace. Epilepsy leads to changes in a person’s life, reduces the quality of his life and worsens his relationships with family and friends. This disease will not allow the patient to drive a car ever again in his life; he will never be able to attend a concert of his favorite band or go scuba diving.

History of epilepsy

Previously, the disease was called epileptic, divine, demonic possession, and Hercules' disease. Many great people of this world suffered from its manifestations. Some of the loudest and most popular names include Julius Caesar, Van Gogh, Aristotle, Napoleon I, Dostoevsky, Joan of Arc.
The history of epilepsy is shrouded in many secrets and mysteries even to this day. Many people believe that epilepsy is an incurable disease.

What is epilepsy?

Epilepsy is considered neuropsychiatric disease chronic course with multiple reasons occurrence. The symptoms of epilepsy are varied, but there are certain specific clinical signs:

• repeated, which are not provoked by anything;
• fickle, transient of man;
• changes in personality and intelligence that are practically irreversible. Sometimes these symptoms develop into.

Causes and features of the spread of epilepsy

In order to accurately determine the epidemiological aspects of the spread of epilepsy, it is necessary to carry out several procedures:

• brain mapping;
• determine brain plasticity;
• explore the molecular basis of nerve cell excitability.

This is what scientists W. Penfield and H. Jasper did, who performed operations on patients with epilepsy. They, to a greater extent, created maps of the brain. Under the influence of current, individual parts of the brain react differently, which is interesting not only scientific point point of view, but also from a neurosurgical point of view. It becomes possible to determine which areas of the brain can be painlessly removed.

Causes of epilepsy

It is not always possible to identify the cause of epilepsy. In this case, it is called idiopathic.
Scientists have recently discovered that one of the causes of epilepsy is considered to be a mutation of certain genes that are responsible for the excitability of nerve cells.

Some statistics

The incidence of epilepsy varies from 1 to 2%, regardless of nationality and ethnicity. In Russia, the incidence ranges from 1.5 to 3 million people. Despite this, individual convulsive conditions that are not epilepsy are several times more common. Almost 5% of the population has suffered at least 1 seizure in their lifetime. Such attacks usually arise from the influence of certain provoking factors. Of these 5% of people, a fifth will definitely develop epilepsy in the future. Almost all people with epilepsy suffered their first seizure in the first 20 years of life.
In Europe, the incidence is 6 million people, 2 million of whom are children. On the planet on this moment There are about 50 million people with this terrible disease.

Predisposing and provoking factors for epilepsy

Seizures in epilepsy occur without any provoking moments, which indicates their unpredictability. However, there are forms of the disease that can be provoked:

• flickering light and ;
• and taking certain medications;
• strong emotions of anger or fear;
• drinking alcohol and frequent deep breathing.

In women, menstruation may become a provoking factor due to changes in hormonal levels. In addition, with physiotherapeutic treatment, acupuncture, active massage activation of certain areas of the cerebral cortex may be provoked and, as a result, the development of a convulsive attack. Taking psychostimulants, one of which is caffeine, sometimes causes an attack.

What mental disorders can occur with epilepsy?

In the classification of human mental disorders in epilepsy, there are four points:

• mental disorders foreshadowing a seizure;
• mental disorders that are a component of the attack;
• mental disorder after the end of the attack;
• mental disorders between attacks.

Mental changes in epilepsy are also distinguished between paroxysmal and permanent. First, let's look at paroxysmal mental disorders.
The first are mental attacks that are harbingers of convulsions. Such attacks last from 1-2 seconds. up to 10 minutes.

Transient paroxysmal mental disorders in humans

Such disorders last for several hours or days. Among them we can highlight:

• epileptic mood disorders;
• twilight disturbances of consciousness;
• epileptic psychoses.

Epileptic mood disorders

Of these, dysphoric conditions are considered the most common. The patient is constantly sad, embittered towards those around him, and constantly fears everything for no reason. From the predominance of the symptoms described above, melancholic, anxious, and explosive dysphoria occurs.
Very rarely there may be an increase in mood. At the same time, the sick person displays excessive and inadequate enthusiasm, foolishness, and clowns around.

Twilight darkness of consciousness

The criteria for this condition were formulated back in 1911:

• the patient is disoriented in place, time and space;
• there is detachment from the outside world;
• inconsistency in thinking, fragmentation in thinking;
• the patient does not remember himself in a state of twilight consciousness.

Symptoms of twilight consciousness

Begins pathological condition suddenly without warning, and the condition itself is unstable and short-term. Its duration is about several hours. The patient's consciousness is gripped by fear, rage, anger, and melancholy. The patient is disoriented, cannot understand where he is, who he is, what year it is. The instinct of self-preservation is significantly muted. During this state Vivid hallucinations, delusions, and inconsistency of thoughts and judgments appear. After the attack ends, post-attack sleep occurs, after which the patient does not remember anything.

Epileptic psychoses

Human mental disorders with epilepsy can also be chronic. Acute cases occur with and without clouding of consciousness.
The following acute twilight psychoses with elements of clouding of consciousness are distinguished:

1. Prolonged twilight states. They develop mainly after full-blown seizures. Twilight continues for up to several days and is accompanied by delirium, aggression, hallucinations, motor agitation, and emotional tension;
2. Epileptic oneiroid. Its onset usually occurs suddenly. This distinguishes it from schizophrenic. With the development of epileptic oneiroid, delight and ecstasy arise, as well as often anger, horror and fear. Consciousness changes. The patient is in a fantastic illusory world, which is complemented by visual and auditory hallucinations. Patients feel like characters from cartoons, legends, and fairy tales.

Of the acute psychoses without clouding of consciousness, it is worth highlighting:

1. Acute paranoid. With paranoia, the patient is delusional and perceives the environment in the form of illusory images, that is, images that actually do not exist. All this is accompanied by hallucinations. At the same time, the patient is excited and aggressive, since all hallucinations are threatening.
2. Acute affective psychoses. Such patients have a depressed, melancholy, angry mood with aggression towards others. They blame themselves for all mortal sins.

Chronic epileptic psychoses

There are several described forms:

1. Paranoid. They are always accompanied by delusions of damage, poisoning, relationships, and religious content. The anxious-angry nature of mental disorders or ecstatic nature is considered specific to epilepsy.
2. Hallucinatory-paronoid. Patients express fragmented, unsystematized thoughts, they are sensual, undeveloped, there are a lot of specific details in their words. The mood of such patients is depressed, melancholy, they experience fear, and clouding of consciousness often occurs.
3. Paraphrenic. With this form, verbal hallucinations occur and delusional ideas are expressed.

Persistent mental disorders of a person

Among them are:

• Epileptic personality change;
• Epileptic dementia (dementia);

Epileptic personality changes

This concept includes several states:

1. A formal thought disorder in which a person is unable to think clearly or think quickly. The patients themselves are verbose and thorough in conversation, but they cannot express the most important thing to their interlocutor, they cannot separate the main thing from something secondary. The vocabulary of such people is reduced, they often repeat what has already been said, use formulaic figures of speech, and insert words into their speech in diminutive forms.
2. Emotional disorders. The thinking of these patients is no different from people with formal thought disorder. They are irritable, picky and vindictive, prone to outbursts of rage and anger, often rush into quarrels, in which they often show aggression not only verbal, but also physical. In parallel with these qualities, excessive courtesy, flattery, timidity, vulnerability, and religiosity are manifested. By the way, religiosity used to be considered specific sign epilepsy, which could be used to diagnose this disease.
3. Character change. With epilepsy, special character traits are acquired, such as pedantry, hypersociality in the form of thoroughness, conscientiousness, excessive diligence, infantilism (immaturity in judgment), the desire for truth and justice, and a penchant for teaching (banal edifications). Such people treat their loved ones with great value and are very attached to them. They believe that they can be completely cured. The most important thing for them is their own personality, their own ego. Moreover, these people are very vindictive.

Epileptic dementia

This symptom occurs if the course of the disease is unfavorable. The reasons for this are not clear at this time. The development of dementia occurs mainly after 10 years of illness or after 200 convulsive attacks.
The progression of dementia is accelerated in patients with low intellectual development.
Dementia is manifested by a slowdown in mental processes and stiffness in thinking.

A long-term mood disorder is sometimes difficult to distinguish from that long-term mental change called an epileptic change in character. This change is an integral part of the disorder of consciousness, and twilight states are still reversible harbingers of a future persistent mental change.

Wealth different options premorbid personality in patients with epilepsy is probably the same as in those individuals who are not subject to convulsive seizures, but the development of personality, which, being built on its interaction with the outside world, is characterized by a certain freedom of decision, suffers damage in the epileptic due to the leveling influence this disease, smoothing out the uniqueness of the individual.

Psychopathological picture. Little by little, the mental reactions generated by the painful process form the core of a new personality, which increasingly displaces the original one. For some time, this old, healthy personality is still fighting for his existence, and the expression of this struggle is the duality and contradictory character traits: willfulness and increased suggestibility, authority and desire for intimate relationships, emphasized, sometimes cloying politeness and outbursts of the most unbridled rage and rudeness , arrogance and sugary servility. For the vast majority, these contradictions are caused by illness, so they cannot be equated with the insincerity, duplicity and hypocrisy of people whose character has not undergone such a pathological transformation.

Even among patients with epilepsy with severe changes, people “with a prayer book in their hands, with pious words on their tongues and with endless baseness in their souls” are rarely encountered, just as “asocial epileptic types” are rare. Bumke doubts that the latter belong to patients with genetic epilepsy, who are rather “oversocial.” Living together with such patients, many of whom, due to changes in the psyche, cannot be discharged even if the seizures stop, increases the reasons for friction and conflict.

The best remedy against this is to move patients into smaller rooms and in smaller groups. Among the patients in our medical institution, more than a third of those suffering from exceptionally large generalized seizures exhibit character changes typical of epilepsy.

Character change when separate forms seizures. Exploring with psychological tests character changes with various forms seizures. Delay and his colleagues found, on the one hand, patients with mildly altered psyches, socially well adjusted and belonging to a narrowed type, and on the other, a more significant group of patients with experiences of an extra-intense type, irritable and unable to control themselves. Patients of the first group suffered predominantly from genuine epilepsy, patients of the second group suffered from epilepsy, mainly symptomatic and especially temporal.

Children with petit mal seizures have more neurotic traits and fewer aggressive tendencies than children with other types of seizures. Patients with nocturnal seizures are often self-centered, arrogant, petty-willed, and hypochondriac. In their respectability and sociability, they are the opposite of undignified and unsociable patients with seizures of awakening, restless, lacking purposefulness, careless, indifferent, prone to excesses and crimes. Already Stauder emphasized the similarity of mental changes in tumors of the temporal lobes with changes in genotype epilepsy according to Gastout, which sees the cause seizures, as well as mental changes in some anomaly of parts of the brain, considering that enecheticity (“viscosity”) is not an integral part of the general epileptic constitution, but a feature that is associated with psychomotor seizures.

Among 60 patients with psychomotor seizures, experts discovered two types clinically and using psychological tests. The first, more frequent, is characterized by reduced activity, slowness, perseveration, a narrowed type of experience, lethargy, a tendency to states of acute arousal and reduced electrical excitability in the form of slow waves on the electroencephalogram (in 72%). The second type is more rare (28%), with normal or slightly increased activity, constant excitability, but without attacks of rage, and increased electrical excitability (the authors classify patients with functional seizures in genuine epilepsy as this type).

Etiology. Epileptic predisposition is a necessary prerequisite for mental changes, which he rarely found in persons with pyknic and leptosomal features, often in patients with the dysplastic type, but especially often with an athletic constitution, as well as in cases with “rich symptoms” and frequent disorders consciousness (in patients with purely motor symptoms, characterological changes are less common). Bumke and Stauder point out significant overlaps between severe chronic character changes, on the one hand, and some prolonged twilight states, on the other, and have no doubt that narcotic drugs, especially Luminal, favor these changes.

In 20% of all cases of therapeutic suppression of grand mal seizures, specialists observed an increase in characterological changes, which weakened again upon the resumption of seizures. According to Selbach, there is antagonism between mental and motor phenomena. Meyer points out the reversibility of epileptic changes in the psyche, which we do not find with organic changes in the psyche with a different genesis. While Stauder and Krishek believe that the typical changes in the psyche that occur during symptomatic epilepsy indicate the role of the epileptic constitution and, in this regard, speak of provoked epilepsy, experts emphasize that undeniably symptomatic epilepsies can lead to severe mental changes. It is hardly possible, however, to exclude with certainty the complicity of moments of predisposition.

Flesk, who sees thoroughness and stiffness as a sign of general brain damage, believes that the vascular processes affecting various departments brain, may have great importance in terms of the diversity of forms of the disease. Scholz and Hager raise the question whether such frequent thalamic changes are one of the conditions for affective disorders.

About the significance of impacts environment we already mentioned; However, this way cannot explain, for example, phenomena such as “prison syndrome”. Mental change is primary symptom, no less, and perhaps even more important, than a seizure. This change is sometimes observed even before the onset of convulsive seizures and becomes more pronounced during twilight states, and epileptic “defect states” can develop without seizures, and among the patient’s closest relatives one can often find people with the properties of enecheticity and irritability.

Electroencephalographic detection of convulsive potentials in relatives of epileptics who do not suffer from seizures and differ in epithymic features, as well as in those patients whose psyche has undergone changes even before the seizures, shows that the basis of both seizures and changes in the psyche is pathological process, and that this process is not in a direct causal relationship with those changes that can be pathologically detected as a consequence of vasospasms accompanying convulsive seizures.

Epileptoid psychopaths. It is possible that the so-called epileptoid psychopaths suffering from childhood bedwetting and night terrors, and subsequently intolerance to alcohol, mood disorders and attacks of poriomania or dipsomania, are individuals in whom the pathological process, fluctuating in intensity and electrobiologically detected partly in dysrhythmias, is expressed exclusively in the vegetative and mental areas. Koch considers the diagnosis "epileptoid psychopathy" legitimate. Among 22 patients in this category who did not suffer from seizures, Weiss found pathological electroencephalograms in 21 patients, and convulsive potentials in 12; of these latter patients, 10 had dysrhythmia in severe or medium degree, and 8 had slow brain potentials. The concept "epileptoid" is only applicable to any mental state from the circle of enechetic constitutions, when in a general and process-less picture this condition is a partial expression of at least one constitutional radical of epilepsy.
Women's magazine www.