Seizures induced by frustration and despair due to unresolved moral and political issues: a rare case of reflex epilepsy
Introduction
The term reflex epilepsy is used to describe a group of rare disorders characterized by seizures evoked only by specific stimuli. Gastaut [6]defined it as an epilepsy in which all seizures, or a large part of them, are reliably provoked by naturally occurring or artificial stimulation of a certain receptor or group of receptors.
The first description of reflex epilepsy is attributed to Gowers [8]who noted that an epileptic seizure could be triggered by “sudden influences such as loud noise, the influence of light, voluntary movement, or sudden muscular tension.” Reflex epilepsy may be classified as simple or complex [4], or categorized according to the specific sensory, motor or cognitive stimuli provoking the attack [3]. These include vision [5], sound [12], reading [1], eating [10], calculation [7], and thinking [18]. Emotional triggers are thought to have a non-specific influence on seizure frequency, and the occurrence of convulsions as a direct and consistent result of a distinct emotion is extremely rare [9]. We present a patient with reflex epilepsy induced by emotions of frustration and despair, triggered by unresolved moral and political issues.
Section snippets
Case report
A 69-year-old man was admitted to the hospital because of clonic movements of the lips and the left hand and incoherent speech, while watching television on the day of admission. The patient had a 6-year history of recurrent episodes of involuntary clonic bucco-lingual movements and tonic flexion of the hands. Each episode persisted for 10–20 s and was not accompanied by loss of consciousness. Seizure onset followed an aura of several seconds duration, consisting of an image of a face of a
Discussion
We present a case of simple partial seizures triggered by specific emotions of agony and despair which, in turn, were brought about by the patient's preoccupation with complex political and moral issues. The emotions described were not the result of an ictal event, as they were not experienced during or after the aura. It was not part of the aura itself, which consisted of a formed visual hallucination. The patient did not have forced thinking as an epileptic phenomenon. Although the thoughts
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Cited by (13)
Moral cognition in neurology
2021, Encyclopedia of Behavioral Neuroscience: Second EditionAffect-induced reflex seizures (AIRS): A case series based on a systematic literature review
2019, Epilepsy and BehaviorCitation Excerpt :A 69-year-old male had a six-year history of focal aware seizures consisting of clonic buccolingual movements and tonic hand flexion following an aura comprising an image of an unrecognized stereotypical face with an expression of “resentment and anger” [43]. Seizures occurred in the aftermath of feeling “frustrated and distressed” in the context of hearing or reading about disasters, political events, or moral issues [43]. These were neither triggered by other negative emotions nor by anger or grief in response to other situations.
Cognition-induced epilepsy
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2002, Epilepsy and BehaviorMoral Cognition in Neurology
2021, Encyclopedia of Behavioral Neuroscience: Volumes 1-3, Second edition