Did Van Gogh's Seizure Disorder Lead to His Infamous Ear Cutting Incident?

[zoobyshoe]

Originally posted by einsteinian77
He was ringo(the guy who held up the diner) in pulp fiction

I saw that. He was really good.

 

[einsteinian77]

They chose well for that movie Roth looks just like Van gogh

 

[zoobyshoe]

Originally posted by hypnagogue
Just curious, why the strong distinction between epilepsy and mental illness? Assuming mental illness is just the result of dysfunctional brain activity, wouldn't epilepsy fall under that category?

This distinction has to do with the perspectives that have been artificially adopted toward the two. Epilepsy has, for roughly 100 years or more, been considered a brain dysfunction. It is universally accepted that the brain as a physical organ of the body is not functioning correctly for purely physical reasons.

"Mental" illness has spent most of the 20th century being regarded as a disease of the "mind". It has really only been in the past thirty years that mental illness has started to be looked at as a result of unbalanced brain chemistry, as a physiological problem.

I realize epileptics are perfectly normal when they aren't having a seizure, but aren't (for instance) bipolar people normal when they aren't on one of their highs or lows?

Actually, I think it is safe to say in the case of bipolars that most of them, when not medicated, are always up, down. or on their way up or down. There aren't natural periods of calm and rest in most cases I've read about.

It's also not universally true that people with seizures are perfectly normal between seizures. Some people with temporal lobe seizures, in particular, experience interesting changes in their personalities that you wouldn't expect. They become very interested in things that require a lot of deep thinking: philosophy, religion, ethics. Some become attracted to artistic persuits for the same reason; as an outlet for the expression of serious modes of thinking. They are not interested in trifles and amusements - just weighty, heavy stuff. They get into writing, lots of writing, writing down their thoughts and philosophies in excruciating detail. One famous neurologist invented a name for this: "hypergraphia". This obsessive philosophizing and voluminous writing can resemble mania somewhat.

The other thing you might notice is emotional volatility between seizures. TLEers tend to get two or three times more emotional about anything than someone else would. the theory is that the limbic system is rendered more tender or touchy by the seizure activity even when the person isn't seizing.

 

[einsteinian77]

I just noticed that up top had advertisements of van gogh art along with razors

 

[zoobyshoe]

Originally posted by einsteinian77
I just noticed that up top had advertisements of van gogh art along with razors

This add service reads the pages, I think, and scans its database for adds that match words mentioned alot. Sick coincidence in this case.

 

[S = k log w]

Originally posted by zoobyshoe
Not just the general public, but a huge percentage of doctors don't know what you just learned about epilepsy. Strangely, some neurologists don't even know it.

The percentage of people with epilepsy who present as mentally ill isn't very large, maybe 10% or less. For a long time, however, all epileptics used to get lumped in with the mentally ill in insane asylums.

Organizations like The National Epilepsy Foundation (or whatever it's called) did a lot of pushing for many years to get the fact that it ever presents as mental illness played down to the point where it became politically incorrect to even allude to it.

Thats fine except that a lot of epileptics started getting incorrectly diagnosed as bipolar and schizophrenic, because no one thought to check for seizures. If you take someone acting strangely to a psychiatrist he will look for a psychiatric cause or something drug related. Seizures?
They haven't a clue.

How can I tell the difference between an Epileptic, a Bi-Polar, and a Schizophenic?

 

[zoobyshoe]

Originally posted by S = k log w
How can I tell the difference between an Epileptic, a Bi-Polar, and a Schizophenic?

Loaded question. Bipolar disorders and schizophrenia are in a constant state of flux regarding their definitions. I have heard a rumor, for instance, that the next edition of the Diagnostic and Statistical Manual of Mental Disorders is going to include a new category of bipolar disorder. (There are currently 4 catagories of bipolar: Bipolar 1, Bipolar 2, Cyclothymic Disorder, and Bipolar Disorder Not Otherwise Specified.)

Psychiatry applies labels according to symptoms. They have never been able to isolate a specific organic cause for "schizophrenia" for example. Instead, research has come up with a bag of miscellaneous possible causes: enlarged ventricles, allergies, viral damage to the brain, and so on. So, there is actually no such animal as "schizophrenia" in the way there is Parkinson's disease or Multiple Sclerosis or Seizure Disorders. The same is true of bipolar.

The difference between seizures and strange behaviour due to other causes can only be definitively proven by detection of seizure activity with an EEG.

The trouble is that the EEG is limited to picking up signals occurring near the surface of the brain. Using the technique of depth implanted electrodes to specifically locate the seizure focus in people being prepared for epilepsy surgery, it was discovered that often the bulk of seizure activity is occurring at depths that will never be picked up with a surface EEG. A study I read found that in the case of simple partial seizures, only 21% showed up on the surface EEG! This presents the physician with the problem that, while an EEG positive for seizure activity rules a seizure in, an EEG negative for seizure activity cannot rule a seizure out.

This being the case, the best course of action is to be sure to include thorough questioning of the patient concerning experiences that are known seizure symptoms. For example, if a person comes with a primary complaint of hearing voices and fear there is a grand conspiracy against them, in depth questioning might also reveal a frequent feeling that they have left their body and are floating above it (simple partial seizure) as well as a peculiar, rising fluttery feeling in the stomach area (simple partial seizure). Then, instead of injecting them with Haldol or Prolyxin, which will just lower the seizure threshold and make things considerably worse, an appropriate medication would be tried.

 

[sandinmyears]

When a psychiatric evaluation is done and Epilepsy is taken into account, it is listed under AXIS III in the evaluation. Axis III is taking into account physical disorders which can also cause psychiatric problems as well. In epilepsy those could (but don't necessarily) include be "Interictal (between seizure/s) Dysphoric Disorder," "Pre-ictal (before seizure/s), Ictal (seizure/s), Post-ictal (after seizure/s), and Interictal (between seizure/s) Depression." Situational depression is also common with a long-term/chronic illness.

Bipolar Disorder and Schizophrenia are Axis I disorders. That is, they are primarily psychiatric disorders. From what I understand, Axis I disorders are usually innate and often genetic. They often "run in families." A person may be genetically pre-disposed toward having Bipolar Disorder or Schizophrenia. Since we see ADHD more often, this is a good example. It is not at all uncommon for one child with ADHD to have sisters or brothers with the same disorder as well. Many adults are also being diagnosed with ADHD as well after their children are first being found to have the disorder.

Axis II disorders are listed in 2 categories. One is "personality disorders." I believe that personality disorders are not thought to be innate or genetic. Often personality disorders come about as a result of circumstances. Child abuse might be an example, (but that's not to say that everyone with a personality disorder was an abused child). The second category in Axis II is "Mental retardation."

 

[zoobyshoe]

As far as I know, when a psychiatric evaluation is done, and epilepsy is taken into account, it is a miracle. Almost never happens in nature.

 

[sandinmyears]

Originally posted by zoobyshoe
As far as I know, when a psychiatric evaluation is done, and epilepsy is taken into account, it is a miracle. Almost never happens in nature.

That's because psychiatrists don't want to tread on the neurologists' territory and vice versa. "Neuropsychology" is a step in the right direction.

 

[zoobyshoe]

Originally posted by sandinmyears
That's because psychiatrists don't want to tread on the neurologists' territory and vice versa.

I'm afraid you are too nice a person for this world to come to this kind conclusion. I think most psychiatrists simply haven't got a clue that epilepsy can present very much like mental illness.

"Neuropsychology" is a step in the right direction.

I haven't heard of this. Are you thinking of "Neuropsychiatry" or is there also "Neuropsychology"?
Two names for the same thing, maybe?

 

[sandinmyears]

Originally posted by zoobyshoe

I haven't heard of this. Are you thinking of "Neuropsychiatry" or is there also "Neuropsychology"?
Two names for the same thing, maybe?

http://www.wkni.org/neuropsych.cfm
http://www.nyuepilepsy.org/cec/nyu_cecservices.jsp?nav=programs
http://www.blackwell-synergy.com/links/doi/10.1046/j.1528-1157.44.s6.10.x/abs/
http://www.neuropsychologycentral.com/

 

[S = k log w]

Much of what you have posted is false. "People with simple and complex seizures do hear voices.."

Only a few people 'hear voices'. Some people hear noises,
few actually hear voices.
I have never heard of anyone attempting to mask any noise with cotton, nor with headphones, nor have I have heard of anyone shout out "Stop them". No one has injured their ears because they attempt to stop the noise or voices. People have had injury to their ears by reason of the fact that they had fallen and injured themselves. I have epilepsy, I had been a medical researcher, and I run two web sites about epilepsy.

Originally posted by zoobyshoe
Actually, people with simple and complex partial seizures do hear voices. They are subject to an incredible variety of physical sensations and sensory illusions.
Each person with epilepsy has his own personal mixture of seizure symptoms. Most forms of epilepsy do not involve any muscular convulsions. The general public is not aware of this.

Also, people who hear disembodied voices try an incredible number of things to silence them. The most popular nowadays is a portable music player with headphones and the volume turned up. People try earplugs, stuffing cotton in their ears, shouting at the voices to "Shut up!", and in some cases they try injuring their own ears. I think this must be a very horrible thing to experience.

Here is a link to an article that speaks about the difficulty sometimes experienced in distinguishing between complex partial seizures and mental illness.

Psychiatric Times
Address:http://www.psychiatrictimes.com/p950927.html

 

[sandinmyears]

Originally posted by S = k log w
Much of what you have posted is false. "People with simple and complex seizures do hear voices.."

Only a few people 'hear voices'. Some people hear noises,
few actually hear voices.
I have never heard of anyone attempting to mask any noise with cotton, nor with headphones, nor have I have heard of anyone shout out "Stop them". No one has injured their ears because they attempt to stop the noise or voices. People have had injury to their ears by reason of the fact that they had fallen and injured themselves. I have epilepsy, I had been a medical researcher, and I run two web sites about epilepsy.

Well, S = k log w, I must just be one of those "few" because those "voices" would scare the jeebers out of me.

 

[zoobyshoe]

Originally posted by S = k log w
Much of what you have posted is false.

No, it is not.

Only a few people 'hear voices'.

What do you mean? Literally only between five and ten? (A few?) I posted links earlier in this thread which show that hearing voices occurs often enough in TLE not to be considered some kind of freak symptom.

few actually hear voices.

It would be more accurate to say what I said, which is that the percentage is small:it is not the most common symptom.

I have never heard of anyone attempting to mask any noise with cotton, nor with headphones, nor have I have heard of anyone shout out "Stop them". No one has injured their ears because they attempt to stop the noise or voices. People have had injury to their ears by reason of the fact that they had fallen and injured themselves.

You are taking my remark about how disturbing it must be to have this experience, in general (which would include when it happens in schizophrenia, bipolar, and in some dementias) and misconstrued it to be a description by me of common ictal behaviour among those who hear voices during seizures.

People who hear voices do, in fact, use all the tactics I described to try and stop them. I mentioned these things by way of describing what a frightening and invasive experience hearing voices can be. A man who lives in my building now who hears them, told me he used to box his own ears in an attempt to deafen himself.

I would guess that most people hearing abusive or terrifying voices during a seizure would not have the presence of mind to do anything in particular about it. Yet they would have the same fear, which was my point.

Van Gogh, if his voices were seizure generated, was atypical in that he did take radical action to stop them. (He was an atypical person in all respects.) Since he was drinking the epileptogenic beverage, absinthe, the night before, and since he was observed having a tonic-clonic seizure some months later, Occam's Razor guides us to suspect a seizure as the cause of his voices.