Epilepsy refers to chronic brain pathologies. For this disease is characterized not only a violation of motor and sensory functions, but also mental, mental. Medical experts also note a personality change that is highly variable. An increase in mental disorders is often observed outside of epileptic seizures. A certain role in this process is played by medication for the treatment of epilepsy.
Epileptic nature
Among neurologists and psychiatrists, there has long been debate about the role that personality disorders play in epilepsy. Some researchers believe that a change in the nature of a sick person is nothing more than a background against which a tendency to convulsive reactions develops, while others emphasize the specific characteristics of a person in this category of patients. This contradiction is due to the fact that the spectrum of disorders in this disease is very large.
In the 70-80s. XX century scientific work has appeared in Russian medical science that confirms the innate character traits in children with epilepsy: stubbornness, explosive behavior and outbreaks of anger, increased affection for parents and friends, excessive hypersociality, anxiety and activity in inappropriate situations.
These and other character traits were revealed in children after the first epileptic seizures, as well as in their relatives who did not tolerate epileptic seizures (pettiness, cruel exactingness to fulfill instructions and other behavioral features).
Endogenous theories
There are several hypotheses that explain the change in character in epilepsy, depending on internal factors:
- Constitutional (hereditary predisposition). According to this theory, a patient with epilepsy is a carrier of congenital socially dangerous qualities of character, and it is possible that he is a descendant of a criminal. Such people are notable for their viciousness, temper, and a penchant for drunkenness and violence.
- Organic - personality changes in epilepsy are associated with organic brain damage.
- A certain localization of lesions. This theory is similar to the previous one, but at the same time, a relationship is established between the location of the epileptic focus in the brain and specific disorders of mental activity.
- The hypothesis of the dependence of mental deviations on the severity of the disease. According to her, the patient’s personality changes against the background of frequent attacks due to the activation of hyper-excitable neurons that are sources of epileptic discharges. This happens 10-15 years after the first incident. Signs of personality changes in epilepsy are increased egocentrism, which replaced the emotional involvement, the frequent manifestation of power lust instead of altruistic traits. There are also studies in which the relationship between such changes on the number of seizures of epilepsy is established.
- The theory of conditionality of personality changes from the form of the disease.
Exogenous hypotheses
The following external factors also affect the nature of a person with epilepsy:
- Medicines It was established that the nature of patients changes not only due to seizures, but also under the influence of antiepileptic drugs (with their long-term use).
- Social components. Personality changes in epilepsy occur under the influence of the social environment and are associated with the patient’s reaction to his illness and the attitude of others (aggressiveness, limitations in everyday life). As a result, patients become very sensitive, vulnerable, touchy, or they form antisocial traits.
Characteristic changes
The most common behavioral features in epilepsy are (listed in decreasing order of occurrence in patients):
- Related to the character: perception of one’s point of view as the only correct one; pedantry; extreme accuracy and following the rules; vindictiveness and revenge; infantilism.
- Violations of thinking and memory: slowness and heaviness; tendency to excessive detail and repetition; epileptic dementia.
- Constant emotional disorders: inertia of the course of mental processes; impulsiveness; explosive manifestation of affect; obsequiousness.
- Temperament changes: increased self-preservation instinct; the prevalence of a gloomy mood, hypochondria.
Forms of the disease
The relationship between personality changes in epilepsy and the form of this pathology is expressed in the following:
- generalized epilepsy, in which the patient loses consciousness during seizures - emotional sensitivity and short temper, inferiority complex;
- waking epilepsy (seizures 1-2 hours after sleep) - stubbornness, isolation, apathy, inability to self-control, lack of discipline, lack of critical assessment, alcohol abuse;
- sleep epilepsy - arrogance, hypochondria, pedantry, egocentrism.
The effect of drugs
Antiepileptic drugs can lead to the following behavioral and cognitive disorders:
- barbiturates ("Benzobamil", "Phenobarbital", "Benzamil", "Benzoal" and others) - deterioration of short-term memory, hyperactivity, aggressiveness, depressive states;
- "Carbamazepine" - aggressiveness;
- "Phenytoin" - increased fatigue, cognitive impairment;
- valproic acid preparations at high doses - aggressiveness, with prolonged use - impaired consciousness;
- succinimides ("Ethosuximide", "Suksilep") - a slowdown in mental processes, irritability, psychosis;
- benzodiazepines ("Gidazepam", "Diazepam") - inhibition, in children - irritability and hyperactivity;
- "Lamotrigine" - aggression, irritability, impulsivity, confusion.
This effect is exerted not only by traditional medicines, but also by new drugs. Despite these negative effects, these drugs are very effective in the treatment of epilepsy.
Infantilism
Infantilism in psychology is a concept denoting immaturity, the preservation of behavioral traits inherent in the previous stages of personality development. In patients with epilepsy, this phenomenon often occurs along with flattering and servility to others.
Experts believe that the decisive role in this is played by a sense of one’s own inferiority, as well as the patient’s desire to hide excessive aggressiveness, to smooth out guilt for uncontrolled impulsive outbreaks. Such patients also often tend to take a passive stance when faced with life difficulties.
Cognitive impairment
Temporary disturbances in the thinking process most often occur with damage to the frontal lobes of the brain in the left hemisphere and represent the following types of disorders:
- impairment of speech (difficulty in making phrases, word selection and understanding);
- a feeling of emptiness in the head, a complete lack of thoughts;
- the inability to recall facts from the past and vice versa, the obsessive appearance of old memories that are not related to the current life.
Temporal epilepsy
The most extensive symptoms of personality changes in epilepsy are detected in lesions of the temporal lobe:
- effects of affectiveness - unjustified bouts of anxiety and fear, emotional instability;
- frequent appearance of guilty feelings, self-reproaches, depression, suicidal attempts, moralizing, intolerance to humor;
- speech disorders - unconscious speaking, amnestic loss of speech, its inconsistency and incoherence, lack of semantic load in logically correct sentences;
- sexual disorders - loss of attraction, exhibitionism, dressing in clothes of the opposite sex, attraction to inanimate objects;
- common psychopathological signs - hallucinations, delirium, schizoepileptoidia.
The earliest signs of damage to the temporal cortex are the loss of memory of past life experiences, while thinking and criticism may persist. Such patients often keep records of events that it is important for them to remember.
Frontal epilepsy
When the convex surface of the frontal cortex is affected near its pole, more serious changes occur - general degradation and epileptic dementia. Affective and volitional disorders predominate in patients (there is slowness, lethargy, apathy, inability to understand the meaning of speech, passive facial expressions), reminiscent of autism in patients with schizophrenia.
If the basal parts of the frontal cortex are damaged, then pronounced behavioral disorders of an asocial nature are observed:
- state of euphoria;
- extreme disinhibition of lower drives (as a rule, increased eroticism, gluttony);
- lack of self-criticism.
In psychiatry, the following types of behavior of such patients are distinguished:
- manic state (agitation, redness of the face, expansion of the eye pupils, tachycardia, excessive salivation);
- reactive hysterical psychosis with a narrowing of consciousness and pronounced childish behavior, violent movements or singing;
- paroxysmal sexual arousal, demonstration of their genitals, passionate postures;
- rage, anger, spasms of the limbs;
- bouts of melancholy, attraction to violent acts, torture;
- indifference, detachment, aimless wandering or stillness without loss or clouding of consciousness.