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THE PSYCHIATRIC PATIENT WITH AN EEG TEMPORAL LOBE FOCUS

Published Online:https://doi.org/10.1176/ajp.120.8.765

1. A group of hospitalized psychiatric patients with an EEG temporal lobe focus without classic psychomotor epilepsy was compared on clinical variables to a control group matched for age, sex and diagnosis. In addition, comparisons were made to a known epileptic group and a random psychiatric group.

2. Aggressive symptomatology in the form of combative behavior and rage episodes, and paroxysmal symptoms in the form of black-outs and hallucinations characterized the temporal lobe groups while a thought disorder in the form of delusions or other more classic psychiatric symptomatology characterized the control groups, in spite of matched diagnosis. Likewise the temporal lobe focus group resembled more clearly the known epileptic group than it did either the control group or the random psychiatric group.

3. It is concluded that this EEG abnormality, even in the absence of overt epilepsy, has clinical psychiatric significance. It should be looked for in patients whose clinical picture has the features that tend to be correlated with this abnormality (Tables 3 and 4) and when present should be given proper diagnostic and therapeutic regard.

4. The data support, in a controlled study, the experimental and clinical observations of others in linking particular types of psychiatric symptoms to temporal lobe (and its rhinencephalic connections) dysfunction.

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