Temporal lobe epilepsy--a syndrome of sensory-limbic hyperconnection

Abstract

Psychological changes in patients with temporal lobe epilepsy are considered. Prior observations of correlated psychiatric diagnoses and objections to these are reviewed. Specific features of behavior and thought, derived from the literature and clinical experience, are suggested as a more effective way of characterizing the interictal syndrome; their accuracy is supported by quantitative results of an ongoing study, Enhanced affective association is proposed as a mechanism underlying these diverse features. This is interpreted in the light of theoretical and experimental accounts that anatomical connection between sensory and limbic structures are established within the temporal lobe. In contrast to sensory limbic disconnection which results in dissociation of stimuli from affective values, it is suggested that the epileptic process effects sensory limbic hyperconnection, leading to a suffusion of experience with emotional coloration.