Abstract
In order to elucidate the role of psychic tension in the precipitation of epileptic seizures, a precise analysis of provoked paroxysmal activities during EEG activation by means of speaking, reading, writing, calculation, and constructive acts was made. This examination, which we call “neuropsychological EEG activation” (NPA), was carried out in a total of 455 patients with epilepsy. In 25 patients out of them, paroxysmal activities, most often associated with myoclonic seizures, were apparently induced by NPA. The factors which were related to the provocation of paroxysmal activities and habitual sei-zures in these 25 patients were:(1) each performance of NPA (16 patients);(2) psychic tension alone (3 paticnts);(3) each performance of NPA as well as psychic tension (6 patients).
A total of 9 patients who belonged to the above mentioned group (2) and (3) were main subjects of this study. In 3 patients of group (2), paroxysmal activities which appeared during NPA were considered to be induced by psychic tension when they were listening to an explanation for tasks and/or when these tasks seemed to puzzle them. Based on such clinical and EEG findings, a proposal for naming these patients as “reflex epilepsy induced by psychic tension” was made. In the other 6 patients of group (3), it was considered that in addition to each task of NPA (e.g. writing, etc.), psychic tension as mentioned above also could play a significant role in the provocation of paroxysmal activities.
The provoked paroxysmal activities were focal (1 patient) and generalized (8 patients): in the former, rhythmic slow activity with spike over the RFp-aT areas could be induced by psychic tension alone; the latter was of simultaneous occurrence over all the areas.
These results suggest that the role of psychic tension cannot be disregarded in the provocation of epileptic seizures precipitated during mental activity.
