Geschwind syndrome

Geschwind syndrome (also called Gastaut–Geschwind syndrome or Waxman–Geschwind syndrome) refers to a set of behavioral traits seen in some individuals who have temporal lobe epilepsy. The condition is named after Norman Geschwind, a researcher who wrote extensively about it between 1973 and 1984. Whether it qualifies as a genuine neuropsychiatric disorder remains debated. In temporal lobe epilepsy, mild, long-term personality changes can develop between seizures. These changes tend to worsen gradually over time. The syndrome involves five main features: hypergraphia, hyperreligiosity, altered (usually reduced) sexuality, circumstantiality, and an intensified mental life. A person does not need to show all five traits to be considered affected. Only a subset of people with epilepsy—or even temporal lobe epilepsy specifically—display these characteristics. Hypergraphia is a strong, compulsive urge to write or draw, observed in people with temporal lobe epilepsy who have had multiple seizures. Those affected pay extreme attention to detail in their writing, sometimes keeping daily diaries that meticulously record ordinary events. In some cases, these writings focus heavily on religious themes. Handwriting in such individuals is often poor. The Russian novelist Fyodor Dostoyevsky, who had epilepsy, is thought to have shown signs of Geschwind syndrome, including hypergraphia. Occasionally, hypergraphia appears as compulsive drawing; these drawings tend to be repetitive, highly detailed, and may blend writing with imagery. Some individuals develop hyperreligiosity, marked by intensified religious feelings and philosophical interests. People with partial (temporal lobe) epilepsy who experience frequent auras—especially auras felt as numinous—tend to report greater spirituality both during and between seizures. Some auras involve ecstatic experiences. It has been suggested that many religious leaders may have had this form of epilepsy. These religious feelings can influence beliefs within any faith, including Vodou, Christianity, Islam, and others. In someone from a strongly religious background, hyperreligiosity might instead appear as deeply held atheism. There are reports of patients converting between religions. A few patients internalize these feelings so much that they deny being religious when asked.