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Biomedical subjects

M R Trimble

Publications and source records attributed to M R Trimble.

At least 109 records · Page 6Linked to original sources
PubMed1988

Personality disorders and epilepsy.

The relationship between epilepsy and personality disorder is viewed. The historical links are discussed, and it is pointed out that the position has moved from that of assuming that everybody with epilepsy will undergo personality change, to noting in particular changes that may be associated with temporal lobe, especially limbic system, abnormalities. The Geschwind syndrome is briefly described, and the association between aggression and epilepsy explored. It is concluded that some aspects of personality may improve following temporal lobectomy, especially if seizures also improve.

Aggression↗
PubMed1988

Cognitive hazards of seizure disorders.

The relationship of a number of epilepsy variables to cognitive decline is reviewed. Underlying brain damage, seizure age of onset, type and frequency, and anticonvulsant drugs are all considered. Two investigations in which subgroups of patients with intellectual deterioration have been compared to those without such deterioration are presented, and certain conclusions are reached with respect to the most important factors that relate to decline. Recurrent tonic-clonic seizures, head injury, the prescription of phenytoin, and low folic acid levels were all related to cognitive decline in one or both of the studies, and the implications of this for the management of epilepsy are noted.

Anticonvulsants↗
PubMed1988

Children of school age: the influence of antiepileptic drugs on behavior and intellect.

The role of antiepileptic drugs in behavior and cognitive function in children is well documented in the literature. In general, behavioral problems occur most frequently with phenobarbital and clonazepam, and appear least often with valproate and carbamazepine. Cognitive impairments occur with phenytoin, are less evident with valproate, and minimal with carbamazepine. Monotherapy, as with adults, leads to improvements in both cognitive abilities and behavior.

Anticonvulsants↗
PubMed1988

Withdrawal symptoms from phenytoin, carbamazepine and sodium valproate.

A prospective, double-blind, placebo-controlled investigation of possible withdrawal symptoms from phenytoin, carbamazepine and sodium valproate is reported in patients with active epilepsy, on combination therapy. There was an increase in seizures on reduction and withdrawal of carbamazepine, but there was no convincing evidence of withdrawal symptoms from any of these drugs.

Adolescent↗
PubMed1988

The psychopathology of the Gilles de la Tourette syndrome. A phenomenological analysis.

Ninety patients with the Gilles de la Tourette syndrome were studied. A high incidence of depression, hostility, and obsessionality was found. Depression was not related to administered medication, while aggression, hostility, and obsessionality were significantly associated with some important features of the syndrome, namely copro- and echo-phenomena and a family history of tics or the Gilles de la Tourette syndrome. Links between psychopathology and neurological and electroencephalographic abnormalities were minimal.

Adult↗
PubMed1988

The neurology of anxiety.

In this article the neurological underpinnings of anxiety are explored. It is suggested that the concept of endogenous anxiety may be a fruitful one. The author notes strong genetic factors in anxiety neurosis, and then goes on to explore the theories of anxiety which emphasize either a peripheral or a central mechanism as primary for the experience. Results from cerebral electrical stimulation and recording highlight the medial temporal structures, supported by data from the epilepsy literature. Animal and human investigations reinforce the rôle of the amygdala and hippocampus and connecting structures in anxiety.

Animals↗
PubMed1988

Carbamazepine and mood: evidence from patients with seizure disorders.

The author reviews the use of carbamazepine in the treatment of epilepsy. The so-called psychotropic effects of carbamazepine were first described after the introduction of the drug to clinical practice in the mid-1960s, and since, several investigators have found relationships between carbamazepine and mood variables in seizure disorder patients. Results of investigations at the National Hospitals, London, suggest that carbamazepine influences behavior disorders, anxiety, and depression in patients with epilepsy. Mechanisms of these psychotropic effects are discussed, including the influence of carbamazepine on limbic-kindled seizures and metabolic effects of the drug. Differences between carbamazepine and other anticonvulsants with regard to effects on mood and behavior are presented.

Affect↗
PubMed1987

Anticonvulsant drugs and cognitive function: a review of the literature.

Alterations of cognitive function are separate from disturbances of behavior seen in association with epilepsy. The nature of the cognitive disability may to a certain extent depend on the seizure type. Partial seizures, mainly derived from a temporal lobe focus, impair memory tasks, while generalized seizures seem to have more effect on attentional abilities. A number of studies, reviewed in this paper, suggest that anticonvulsant drugs further impair cognitive function. Maximal impairments are seen in patients receiving polytherapy: rationalization of polytherapy improves cognitive abilities. Studies in children and adults have allowed differentiation of the effects of various commonly used antiepileptic agents. Maximal cognitive deficits are seen with phenytoin, while phenobarbital and sodium valproate induce moderate disturbances, and carbamazepine seems relatively free from such toxicity. Further research is needed on the interrelationship between types of seizure disorders, types of anticonvulsant medications, and cognitive function.

Anticonvulsants↗
PubMed1987

Magnetic resonance imaging in psychiatry.

Magnetic resonance imaging (MRI) is a relatively new radiological technique that may be useful in the study of psychiatric illness. MRI gives detailed structural information about the brain and also allows quantification of functional change. Current areas of study relevant to psychiatry include: schizophrenia, dementia, epilepsy and, to a lesser extent, alcohol and affective disorders. The authors review the basic principles of MRI, discuss the recent application to psychiatry, indicate its potential advantages and comment on the current limitations of this imaging modality.

Brain↗
PubMed1987

Psychiatric aspects of epilepsy.

The relationship between epilepsy and psychiatry is reviewed. It is concluded that patients with epilepsy display more psychopathology than control populations and that patients with temporal lobe epilepsy are especially susceptible to more severe psychiatric illness. Psychosis, particularly with a schizophrenia-like presentation seems associated with dominant hemisphere pathology especially with altered function. The relationship between personality disorder and epilepsy is less clear. Affective disorder is a common clinical problem, although earlier reports of a link with the non-dominant hemisphere have not been replicated in some recent studies. The problem of cognitive decline is examined and it is concluded that many patients with epilepsy show either selective or more generalized impairments of abilities. This may be related to the effects of anticonvulsant drugs, and the possibility that carbamazepine may possess psychotropic properties is noted.

Anticonvulsants↗