A neuropsychological comparison of schizophrenia and schizophrenia-like psychosis of epilepsy.

Background: The schizophrenia-like psychoses of epilepsy (SLPE) might represent a secondary form of schizophrenia in which the pathology is relatively confined to the temporal lobe. To test this possibility we have compared the neuropsychological profile of schizophrenia and SLPE. Our main hypothesis was that both psychotic groups would show deficits of temporal lobe function but that prefrontal impairment, as measured by tests of executive function, would be found only in the primary schi ophrenic group.

SPET study of verbal fluency in schizophrenia and epilepsy.

Background: The association between temporal lobe epilepsy and schizophrenia suggests that the critical abnormality may be pathology within the temporal lobes. People with schizophrenia-like psychosis of epilepsy (SLPE) provide a useful group in which to examine the importance of temporal and frontal lobe dysfunction in schizophrenia.

Method: A verbal fluency activation paradigm and a 99mTc HMPAO SPET were used to study frontotemporal function in people with SLPE (n = 12), schizophrenia (n = 11) and epilepsy (n = 16).

An unusual presentation of multiple sclerosis.

Two male patients who presented with unusual pictures of dementia in the absence of other obvious symptoms or signs are reported. Investigations demonstrated changes highly suggestive of multiple sclerosis (MS) on magnetic resonance imaging, cerebrospinal fluid analysis and electrophysiological tests. We suggest this represents a rare presentation of multiple sclerosis.

A pilot study of schizophrenia-like psychosis in epilepsy using single-photon emission computerised tomography.

In a pilot study, SPECT was used to explore differences in rCBF between a group of patients with schizophrenia-like psychoses of epilepsy (SLPE) and a matched group of epileptic controls. Five patients in each group were investigated and those with SLPE showed significant reductions in the index of rCBF in the left medial temporal region. These differences are being investigated further.

Severe psychiatric disturbance and abnormalities of the corpus callosum: review and case series.

The association between developmental defects of the corpus callosum and major psychiatric disturbance is discussed with a review of published cases. Seven new cases are presented, of which four had clear psychotic symptoms, two receiving a diagnosis of schizophrenia. Of the remainder, one had a developmental disorder affecting social interaction and speech which could be classed as Asperger's syndrome, one had a personality disorder with depressive and conversion symptoms, and the last was an adolescent boy with severe behavioural problems.

The effect of anticonvulsants on cognitive functioning following a probable encephalitic illness.

A 54-year-old man developed an acute encephalitic illness and subsequently suffered from marked memory difficulties. Considerable improvement with anticonvulsant therapy was demonstrated using a ward-based observation programme and serial neuropsychological assessments. The case report highlights the prominent role played by epileptic activity in determining the severity of the patient's amnesia.

Neuroradiological and neuropsychological assessment in anorexia nervosa.

Seventeen patients with anorexia nervosa were examined by computed tomography (CT) and psychometry and compared with ten normal control subjects. The patients were found to have enlarged external cerebrospinal fluid spaces compared to controls. No differences were found in ventricular size and X-ray absorption density measurements between patients and controls.

Patterns of neuropsychological deficit in alcoholic Korsakoff's syndrome.

Twenty-five male and 13 female patients with alcoholic Korsakoff's syndrome (AKS) were compared with age- and sex-matched non-Korsakoff chronic alcoholics and healthy volunteers in a neuropsychological study, which included computer-administered tests of cognitive function. The performance of male Korsakoff patients was significantly inferior to that of healthy male controls, not only in tests of memory, but also in visuo-perceptual tasks with a speed or motor component, and on category sorting and verbal fluency measures. Compared with male alcoholics, the performance of male Korsakoff patients was again inferior on similar tests.

Alcohol and the brain.

Some of the major effects of alcohol, and alcoholism, on the brain are reviewed, with reappraisal of evidence drawn from brain imaging, neuropathology, clinical psychology, and laboratory experimental work. A hypothesis is developed which may help to account for the wide variability encountered in individual susceptibility to alcoholic brain damage and its varied manifestations. Therapeutic implications are considered.

Cortical and diencephalic lesions in Korsakoff's syndrome: a clinical and CT scan study.

Twenty-five male alcoholic Korsakoff patients were compared with age and sex-matched non-Korsakoff chronic alcoholics and healthy volunteers on clinical and CT brain scan parameters. The scans were assessed by planimetry, visual grading procedures and computerized analysis. Reliable measures of third ventricular size were developed.

Physiogenesis and psychogenesis in the 'post-concussional syndrome'.

The aetiological factors relevant to the development of post-concussional symptoms are reviewed. From the numerous studies carried out to date, it would appear that both physiogenic and psychogenic influences are important in their genesis. However, where mild-to-moderate injuries are concerned, organic factors are chiefly relevant in the earlier stages, whereas long-continued symptoms are perpetuated by secondary neurotic developments, often of a complex nature.

Early-onset Huntington's chorea. Diagnostic clues.

A patient with early-onset Huntington's chorea is described. The diagnosis had been overlooked during previous contacts with psychiatric services because there was no family history, and features typical of the adult disease were absent. Distinctive findings on CT scan and electroencephalography were observed.

Selective memory loss and global intellectual deficits in alcoholic Korsakoff's syndrome.

The principle of distinguishing between selective memory deterioration and global intellectual decline has been applied to 38 patients with alcoholic Korsakoff's syndrome. Indices were developed for each type of deficit and their distributions explored. Considerable variation was seen in both parameters, the transition from pure memory loss to global intellectual deficits appearing to be gradual.

Psychiatric presentation of Creutzfeldt-Jakob disease. A case report.

A patient with Creutzfeldt-Jakob disease is described. Many alternative psychiatric diagnoses were considered, and the true situation only became apparent late in the clinical course.

Memory and ventricular size in alcoholics.

The relationship between memory performance and CT scan measures of ventricular size was investigated in a sample of 39 chronic alcoholics and 39 controls. Measures of verbal, non-verbal, recognition and recall memory were derived from the tests administered and were viewed in relation to the lateral ventricle and third ventricular size measurements. The results showed that the memory performance of male alcoholics was significantly related to measures of third ventricular size, but probably not to measures of the lateral ventricles.

Cholinergic effects on constructional abilities and on mnemonic processes: a case report.

The effects of physostigmine on test performance of a patient with multiple cognitive deficits were observed in a double-blind, placebo-controlled study. Scores on tests of learning and memory and tests of visuo-spatial and constructional ability were both improved by physostigmine, while lecithin improved scores only on the former tests.