0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
Letter   |    
In Reply
Orrin Devinsky, M.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2003;15:456-a-457. doi:10.1176/appi.neuropsych.15.4.456-a

SIR: Dr. Derakshan accurately summarizes the literature on temporal lobe seizures and impairment of verbal consciousness and speech automatism. Verbal consciousness is impaired by dominant temporal lobe seizures and automatic speech (resulting from preserved dominant speech cortex) occurs most often with nondominant temporal lobe seizures. However, our study concerned nonepileptic conversion seizures.

I strongly disagree with his assertion that one should never diagnose conversion symptoms or conversion disorder in a patient with a "neurological" disorder. Indeed, there is extensive literature suggesting that patients with structural brain lesions (e.g., tumor, stroke, multiple sclerosis, trauma) or neurophysiological disorders such as epilepsy have an increased incidence of conversion disorder.14 I would also disagree about any data on lateralized ictal motor automatisms and hemispheric dominance. Rather, partial seizures with lateralized ictal motor automatisms usually start from the ipsilateral hemisphere.5

Barry E, Krumholz A, Bergey GK, et al. Nonepileptic posttraumatic seizures. Epilepsia. 1998;39:427—31
 
Eames P. Hysteria following brain injury. J Neurol Neurosurg Psychiatry 1992;55:1046—  1053
 
Caplan LR, Nadelson T. Multiple sclerosis and hysteria. JAMA 1980;243:418—421
 
Devinsky O, Mesad S, Alper K. Hemisphere lesions and conversion nonepileptic seizures. J Neuropsychiatry Clin Neurosci 2001;13:367—73
 
Chee MW, Kotagal P, Van Ness PC, et al. Lateralizing signs in intractable partial epilepsy: blinded multiple-observer analysis. Neurology 1993;43:2519—25
 
+

References

Barry E, Krumholz A, Bergey GK, et al. Nonepileptic posttraumatic seizures. Epilepsia. 1998;39:427—31
 
Eames P. Hysteria following brain injury. J Neurol Neurosurg Psychiatry 1992;55:1046—  1053
 
Caplan LR, Nadelson T. Multiple sclerosis and hysteria. JAMA 1980;243:418—421
 
Devinsky O, Mesad S, Alper K. Hemisphere lesions and conversion nonepileptic seizures. J Neuropsychiatry Clin Neurosci 2001;13:367—73
 
Chee MW, Kotagal P, Van Ness PC, et al. Lateralizing signs in intractable partial epilepsy: blinded multiple-observer analysis. Neurology 1993;43:2519—25
 
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Books
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 62.  >
Dulcan's Textbook of Child and Adolescent Psychiatry > Chapter 10.  >
DSM-5™ Clinical Cases > Chapter 17.  >
The American Psychiatric Publishing Textbook of Psychopharmacology, 4th Edition > Chapter 62.  >
DSM-5™ Clinical Cases > Chapter 8.  >
Topic Collections
Psychiatric News
APA Guidelines
PubMed Articles