Geschwind syndrome

Geschwind syndrome, also known as Gastaut-Geschwind, is a group of behavioral phenomena evident in some people with temporal lobe epilepsy. It is named for one of the first individuals to categorize the symptoms, Norman Geschwind, who published prolifically on the topic from 1973 to 1984. There is controversy surrounding whether it is a true neuropsychiatric disorder. Temporal lobe epilepsy causes chronic, mild, interictal (i.e. between seizures) changes in personality, which slowly intensify over time. Geschwind syndrome includes five primary changes; hypergraphia, hyperreligiosity, atypical (usually reduced) sexuality, circumstantiality, and intensified mental life. Not all symptoms must be present for a diagnosis. Only some people with epilepsy or temporal lobe epilepsy show features of Geschwind syndrome.

Hypergraphia is the tendency for extensive and compulsive writing, and has been observed in temporal lobe epilepsy patients who have had multiple seizures. Those with hypergraphia have extreme attention to detail in their writing. Some patients keep diaries and write down meticulous details about their everyday lives. In certain cases, the writing of patients has demonstrated extreme interest in religious topics. Also, these individuals tend to have poor penmanship. The novelist Fyodor Dostoyevsky showed symptoms of Geschwind syndrome, including hypergraphia.

Some individuals may exhibit hyperreligiosity, characterized by increased, usually intense, religious feelings and philosophical interests, and partial (temporal lobe) epilepsy patients with frequent numinous-like auras have greater ictal and interictal spirituality. Some seizures include ecstatic experiences. It has been reported that many religious leaders exhibit this form of epilepsy. These religious feelings can motivate beliefs within any religion, including Voodoo, Christianity, Islam, and others. Furthermore, in Geschwind syndrome, "in someone from a strongly religious background hyperreligiosity might appear as deeply felt atheism". There are reports of patients converting between religions. A few patients internalize their religious feelings: when asked if they are religious they say they are not. One reviewer concluded that the evidence for a link between temporal lobe epilepsy and hyperreligiosity "isn't terribly compelling".

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