Epileptoid

EPILEPTOID, Many psychiatrists (Kretschmer, Bonhoeffer, Delbrück, among the Russians Gannushkin, Gurvich, etc.) consider that just as schizophrenia grows on the soil of a schizoid constitution and in families of schizophrenics there are many schizoids (see.)—people with peculiar features of character reminiscent of their symptoms of pronounced schizophrenia, so in families of epileptics there are many persons with features reminiscent of individual traits of epileptic personality degeneration—epileptoids. Krapelin in his textbook already pointed out in 1908 that 'psychopathic personalities are encountered, the peculiarities of which force one to think of their close relation to epileptic personality degeneration. These are, first of all, certain irritable, petty, overly pious pedants and, secondly, certain limited, angry, emotionally dull boors.' 'Further clinical experience,' adds Krapelin, 'will show how correct it is in such cases to speak of "epileptoid personalities".' Roemer already in 1910 described 2 families in which during three generations many persons with 'gloomy-irritable mood, prone to violent outbursts of excitement' were encountered, and in addition, in all three generations there were also epileptics. Roemer considers that epilepsy in these families developed on the soil of this inherent to the families epileptoid 'irritable' character. Devonport in 1915 described a series of pedigrees where a 'violent temper' was persistently maintained. In 1921 F. Minkowska described a family in which there were many persons with condensed clinging affectivity, persistently holding to their home, their family, their things, unable to adapt to new conditions of life, extremely punctual, neat. She named this type of temperament 'glycroid'. In view of the fact that in this same family there were also pronounced epileptics and the very type of character of glycroid persons resembles viscosity, neatness in epileptic personality degeneration, Minkowska classified glycroids as E. (this same type of epileptoid character Mautz not very successfully called 'hypersocial', and Seriysky 'defensive'). Thus, just as Kretschmer established bipolarity for schizoids: expansive-sensitive, for E. bipolarity was established: excitable-viscous (getrieben-bounded Delbrück). A whole series of authors (Kleist, Roden, Gründler, Delbrück, Andreev, Seriysky, etc.) also finds a certain correlation between epileptics and E. in regard to body build: massive-athletic (mainly excitable E.) or dysplastic body build. Many psychiatrists (Gurvich, Folland, Enke, Lipmann) find motor peculiarities (angularity, clumsiness, viscosity, poverty of movements) in athletes and dysplastics, pointing out that these peculiarities are more closely connected with character than with body build. Under the influence of psychogenic traumas in pronounced E., as in other constitutionally inadequate persons, psychotic reactions may arise. Gannushkin considers that an epileptoid can give a psychotic reaction: 1) a picture of great motor excitement; 2) a picture of mood disorders with the character of melancholy, anxiety, fear, anger; 3) a picture of twilight states and 4) a picture of pseudodementia. Close to epileptoids are those psychopaths whom Bratz and Leubuscher described under the name of affect-epileptics. However, it should be noted that a whole series of psychiatrists (K. Schneider, Hoffman, Cap, etc.) consider the concept of E. unclear, very indefinite and point out that in genealogical research of families of epileptics one does not encounter people with epileptoid character nearly so often, and therefore there are not quite sufficient data to refer all excitable persons to the epileptoid circle. Cap (E. Cap) in his classification of psychopaths retains separate classes—erregbare, explosible, reizbare—of psychopaths, not mentioning E. It is undoubtedly that the hereditary relations in epilepsy are even more complex than in schizophrenia; it is undoubtedly that exogenous factors have very great significance in epilepsy [according to recent research (A. Rosanoff, America) out of 23 monozygotic twins with epilepsy only in 14 cases did both twins suffer from epilepsy, the same data on epileptic twins were obtained by Strossler and Schulte]; it is undoubtedly that the description of epileptoid character is even less accurate than the description of a schizoid, however the efforts of constitutional psychiatry to elucidate the epileptoid character are very interesting, although they still require further research.