Affective Disorders in Epilepsies: A Neuropsychiatric Review

Abstract

Psychiatry and neurology are well-established as separate disciplines and they may view an issue of mutual concern, such as affective disorder in people with epilepsy, from such different premises that the important synthesis of behavioural neurology, or neuropsychiatry, will be made ineffective. Nosological problems stemming from the use of diagnostic manuals are discussed and revealed in case reports. Reports of affective disorder in persons with brain disorders are relatively rare, possibly as a consequence of nosological problems which stem from a maintenance of a tradition of "functional" disorder. New cases of bipolar disorder and organic mania are given with commentary on the preponderant lateralization of cerebral dysfunction to the right cerebral hemisphere in manic cases.

Case Study: Antimanic Effectiveness of Dextroamphetamine in a Brain-Injured Adolescent

“…Only one child had an increase in symptoms. We agree with Taylor's (1989) view that there is much overlap between Ounsted's hyperkinetic syndrome and hypomania and that hypomania may be a more heuristic description of the condition in view of evidence of mania and especially depression in Taylor's follow-up ofchildren like these. Inconsistencies included the profound sleep noted and lack of mention of discrete episodes in Ounsted's group.…”

Adolescent Heavy Episodic Drinking: Neurocognitive Functioning during Early Abstinence

“…The thrice-repeated neuropsychological (NP) battery assessed five key domains: (1) executive functioning , (2) learning and memory , (3) visuospatial construction , (4) working memory, attention, processing efficiency, and psychomotor speed , and (5) language and achievement . Standardized neuropsychological tests included the Wechsler Abbreviated Scale of Intelligence (WASI; Wechsler, 1999) Vocabulary and Block Design; Wechsler Adult Intelligence Scale-III (WAIS-III; Wechsler, 1997): Arithmetic, Digit Span, and Digit Symbol; California Verbal Learning Test - Second Edition (CVLT-II; Delis, Kramer, Kaplan, & Ober, 2000); Rey-Osterrieth and Taylor Complex Figures copy and 30-min delayed recall (Osterrieth, 1944; Strauss & Spreen, 1990; Taylor, 1989); Delis-Kaplan Executive Functioning System (D-KEFS; Delis, Kaplan, & Kramer, 2001) Trail Making and Color-Word Interference; a modified version of the Memory for Intentions Test (MIST; Raskin & Buckheit, 1999) to examine prospective memory; and the Wide Range Achievement Test-4 (WRAT-4; Wilkinson & Robertson, 2006) Reading subtest. Alternate forms were used when possible to reduce practice effects (i.e., Rey-O figure at times 1 and 3, and Taylor figure at time 2; alternation of CVLT-II lists also).…”

“… Note: SS = scaled score; Complex Figure = Rey-Osterrieth and Taylor Complex Figures copy and 30-minute delayed recall (Osterrieth, 1944; Strauss & Spreen, 1990; Taylor, 1989); D-KEFS = Delis-Kaplan Executive Functioning System (Delis, Kaplan, & Kramer, 2001); CVLT-II = California Verbal Learning Test - Second Edition (Delis et al, 2000); MIST = Memory for Intentions Test (Raskin & Buckheit, 1999); WASI = Wechsler Abbreviated Scale of Intelligence (WASI; Wechsler, 1999); WAIS-III = Wechsler Adult Intelligence Scale-III (Wechsler, 1997; WRAT-4 = Wide Range Achievement Test-4 (Wilkinson & Robertson, 2006) a Initial group difference (at Time 1) but no group × time interaction b Initial group difference (at Time 1) and group × time interaction at 3 c Group difference …”

Development of mania in close association with tricyclic antidepressant administration in Children. A report of two cases

“…case reports such as these we cannot be certain that the manic episodes were precipitated by the administration oftricyclic antidepressants, or whether they would have occurred naturally. Indeed, case 2 was predisposed to bipolarity by several factors that are recognised correlates of mania, namely a family history of severe affective disorder (Strober et al, 1988), dysfunction of the right cerebral hemisphere (Taylor, 1989;Cutting, 1992), hypothyroidism (which is a correlate of bipolar disorder in adults (Cowdry et al, 1983)) and by the administration of thyroxine (Goodwin &Jamison, 1990). However, the finding that in both cases there was a very close temporal association between tricycfic antidepressant administration and the development of mania certainly raises the possibility of a direct causal relationship.…”