Abstract
Compulsive production of verse is an unusual form of hypergraphia that has been reported mainly in patients with right temporal lobe seizures. We present a patient with transient epileptic amnesia and a left temporal seizure focus, who developed isolated compulsive versifying, producing multiple rhyming poems, following seizure cessation induced by lamotrigine. Functional neuroimaging studies in the healthy brain implicate left frontotemporal areas in generating novel verbal output and rhyme, while dysregulation of neocortical and limbic regions occurs in temporal lobe epilepsy. This case complements previous observations of emergence of altered behavior with reduced seizure frequency in patients with temporal lobe epilepsy. Such cases suggest that reduced seizure frequency has the potential not only to stabilize or improve memory function, but also to trigger complex, specific behavioral alterations.
Highlights
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We present a patient with transient epileptic amnesia and a left temporal seizure focus, who developed isolated compulsive versifying, producing multiple rhyming poems, following seizure cessation induced by lamotrigine
Examples include pathological gambling, punding, and hypersexuality associated with dopaminergic replacement in Parkinson's disease (Joutsa, Martikainen, & Kaasinen, 2012), hyper-religiosity associated with focal temporal lobe atrophy (Chan et al, 2009), heightened visual creativity and production of art in frontotemporal dementia (Miller et al, 1998; Seeley et al, 2008), and musicophilia associated with degenerative and epileptic processes involving the mesial temporal lobes (Fletcher, Downey, Witoonpanich, & Warren, 2013; Rohrer, Smith, & Warren, 2006)
Summary
Warrena a Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK b Specialist Mental Health Team for Older People, The Meadows, Hertfordshire Partnership NHS Foundation Trust, Hertfordshire, UK c Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London, UK Published online: 26 Aug 2014. To cite this article: Ione O.C. Woollacott, Phillip D.
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