Psychiatric Symptoms Associated With Lesions of Temporal Lobe

The tumoral Tempororhinencephalic Syndrome of the Dominant Hemisphere

“…The role of rliinencephalon in precipitating autonomic and affective behavious disturbances has been known since the works of Spiegel and Hunsicker [23], Papez [19], Kliiver and Bucy [12], Mac Lean [16], Griinthal [8], Langworlhy [13], Mulder and Daly [18], Mackay [15], Delgado [7], Hoff el al. [11], Belloni and Terzian [2], Haberland [9].…”

Ictal Pleasant Sensations: Cerebral Localization and Lateralization

“…Hi, Hippocampus; TBa, temporobasal anterior; TBb, temporobasal medial; TBc, temporobasal posterior; focal epileptic (spike) activity, temporobasal and gyrus temporalis inferior (TBa 6,7,8,12, and later in the hippocampus area). Electrode TBa 8 records from gyrus temporalis inferior.…”

“…Lennox and Cobb (7) noted unpleasant aurae in 5.5% of their patients and pleasant sensations in 1.2%. No definite proof has been found of a possible cerebral localization of ictal happiness, although in single cases, a tumor or EEG abnormalities were found in the temporal lobe (8)(9)(10)(11). Presurgical evaluation for epilepsy surgery now offers optimal conditions for the localization of focal epileptic activity and the correlation to behavioral changes including psychic or autonomic ictal signs (12).…”

The Psychobiology of Consciousness

“…The probability that Heath's patients were not schizophrenic was noted by Monroe (1959). The Mayo group, however, described the affectual symptoms and "queer or unusual behavior" in their series of a hundred patients with temporal lobe spikes without resort to the diagnosis of schizophrenia (Mulder & Daly, 1952) and also noted that such behavior was quite distinct from the epileptic symptoms. Temporal lobe spiking is related to the personality features of patients with temporal lobe syndromes, including hyposexuality, religiosity, and emotional lability and intensity, because (except for "viscosity" and obsessiveness) changes in personality constellation are demonstrable following the removal of the spike focus during temporal lobe surgery or successful treatment with anticonvulsants (Falconer, Serafetinides, & Corsellis, 1964;Geschwind, 1973;Falconer, 1973).…”

“…Thus, it appears that hippocampal-septal hyperexcitability induced by loss of electrophysiological inhibition from below or direct electrical stimulation leads to increases in excitability lasting months or years (Andy, Chinn, Allen, & Shawver, 1958;Andy, Chinn, Bonn, & Allen, 1958;Andy & Mukawa, 1960;Chatrian & Chapman, 1960;Delgado & Selvillano, 1961;Goddard et al, 1969;Racine et al, 1975;Sato, 1975), associated with the following features: a behavioral syndrome dissociatable from pure motor seizure phenomena in man and animals (Andy & Akert, 1955;Delgado & Hamlin, 1960;Delgado & Selvillano, 1961;Feindel et al, 1952), with interictal personality and behavioral features that are characterized by affectual and paranoid components (to use psychiatric parlance) (Ervin et al, 1955;Gastaut, 1978;Gibbs, 1951;Heath, 1954;Hill, 1952;Mulder & Daly, 1952) and that can be modified by changes in the synchronous electrical discharges (Blumer & Walker, 1967;Falconer, 1973;Falconer et al, 1964;Geschwind, 1973;Peters, 1971). The hippocampus now becomes a focal point for further analysis, particularly in relation to permanent changes produced there that may be invoked by drugs reducing inhibitory serotonin regulation of temporallobe limbic function and producing transcendent consciousness.…”