Behavior in epileptic children

Abstract

It therefore becomes evident that the electroencephalogram has demonstrated a pathologic basis or consistent foundation (cerebral dysrythmia) for the syndrome best known as “idiopathic epilepsy.” The various patterns of cerebral dysrythmia are typical and characteristic for the specific types of epilepsy. They may be easily identified. The electrogram also has demonstrated an organic basis for some of the behavior disturbances or personality defects peculiar to epileptics. This is a confirmation of the “abnormal mental states”1 diagnosed clinically before the advent of the electronic apparatus. Except for the “psychomotor” and the “thalamic” syndromes described above, the epileptic child does not start out with an inherent personality defect or disorder. However, because of his seizures and the social reactions and restrictions which they evoke he is gradually surrounded by barriers and frustrations which tend to create emotional disorders. It is most important that physicians become aware of the organic causes of behavior disturbances and particularly of the various manifestations of epilepsy. The juvenile delinquent is entitled to a complete medical and psychiatric survey. This must include an electrogram made and interpreted by competent individuals, not just “laboratory” technicians. The epileptic child with a psychomotor or thalamic syndrome, or with temporary confusional states may well be guilty of shocking crimes, even murder, for which he is legally but not morally responsible. Such a child deserves every consideration as a patient before he is branded a criminal. Treatment of the epileptic child today requires a thorough understanding of the type and character of seizure or disorder present. An electrogram is essential for the distinction and confirmation of the diagnosis. While phenobarbital is almost a specific for the control of grand mal or major seizures of idiopathic epilepsy, Phenacemide (Phenurone), introduced in 1948, is the first compound we have ever had that definitely controls a number of children with this syndrome. It is a toxic compound which must be given with caution and under close supervision.18 However, when we treat diseases as serious as epilepsy we must use heroic measures if necessary. Gemonil has also been effective in the treatment of some of the syndromes. It therefore becomes evident that the electroencephalogram has demonstrated a pathologic basis or consistent foundation (cerebral dysrythmia) for the syndrome best known as “idiopathic epilepsy.” The various patterns of cerebral dysrythmia are typical and characteristic for the specific types of epilepsy. They may be easily identified. The electrogram also has demonstrated an organic basis for some of the behavior disturbances or personality defects peculiar to epileptics. This is a confirmation of the “abnormal mental states”1 diagnosed clinically before the advent of the electronic apparatus. Except for the “psychomotor” and the “thalamic” syndromes described above, the epileptic child does not start out with an inherent personality defect or disorder. However, because of his seizures and the social reactions and restrictions which they evoke he is gradually surrounded by barriers and frustrations which tend to create emotional disorders. It is most important that physicians become aware of the organic causes of behavior disturbances and particularly of the various manifestations of epilepsy. The juvenile delinquent is entitled to a complete medical and psychiatric survey. This must include an electrogram made and interpreted by competent individuals, not just “laboratory” technicians. The epileptic child with a psychomotor or thalamic syndrome, or with temporary confusional states may well be guilty of shocking crimes, even murder, for which he is legally but not morally responsible. Such a child deserves every consideration as a patient before he is branded a criminal. Treatment of the epileptic child today requires a thorough understanding of the type and character of seizure or disorder present. An electrogram is essential for the distinction and confirmation of the diagnosis. While phenobarbital is almost a specific for the control of grand mal or major seizures of idiopathic epilepsy, Phenacemide (Phenurone), introduced in 1948, is the first compound we have ever had that definitely controls a number of children with this syndrome. It is a toxic compound which must be given with caution and under close supervision.18 However, when we treat diseases as serious as epilepsy we must use heroic measures if necessary. Gemonil has also been effective in the treatment of some of the syndromes.