1994


:


.
Epilepsy
)(

( Electro Encephalo Gram ( E.E.G .
.

Covulsions
. Grand
Mal Fits
.
Hysterical Fits


.



Temporal Lobe Epilepsy
. Pscho Motor Epilepsy

- Dissociative Type
Cofusion Delirium
Hysterical Fugue ) (Roth, 1973
Phobic Anxiety Depersonalization
Syndrome
.
Obsessive Compulsive Neurosis
Impulses .
Schizophrania
Paranoid Ideas ) . Persecutary Delusions
1982 . ( 156 106

 :

.

.



) 1980 Lida , 231
. ( etal. 1986


.
: -:



.
Cerebral
Cortex ( Subcortex 1797 1982
Bannister, 1978, Walton,1979, Samuel, 1982 1985
Epileptic
Focus .
) Lechtenberg, 1984, Al-Garem, 1979
(,1985

.
Dazed Lock
Hallucinatory Experience
Visual Illusions
) . ( Lechtenberg, 1985
_ ) (
.
:
- Aetiological Classification:

:
-1 Idiopathic

 Primary
.
- - . 75
% .
-2 Symptomatic

) ( . Secondary
. % 25 .
: Clinical

. :
-1 Generalized

. .
:
- Non Convulsive
Petit Mal .Absence

.
- Convulsive Grand Mal
Tonic
.
Clonic .
- -
.

. .
. Status Epilepticus
Myoclonic Epilepsy
.
.Febrile Convulsions
-2 Partial

.
:
- Simple
... . :
-1 Sensory Fits
.

) ( .
.sensory Jacksonian fits
4

 -2 Motor Fits

. motor Jacksonian fits

.
-3 Autonomic


....
- Complex
.
. .
.
:
-1 Automatism

.

.
.
) (
... .
-2
.
: Electroencephalographic

. :
-1 Focal Cortical

.
-2 Subcortical

. Centrencephalic
-3 Diffuse Cerebral
)
)4850 43 42 101624303337
_ :
-1 :
_ 400 . _ .
Automatism " :

.
5


". ( Lennox , 1960 ) .
.
) ( Jackson, 1899 Uncinat fit
. 1937
) (Gibs, etal., 1937
.
Penfield & Jaspers 1954
. Gastaut 1970
Complex Partial Epilepsy .
- -
.
) ( Lishman, 1978

Anatomical
.

% 20 .


. ) ( Kaufman, 1981

.
-2 :


.
)
( Lechtenberg, 1985

Orientation
. )Blumer,
. ( 1975 Fenton, 1981a,Degladow, 1984
:
Pre- ictal Aura I
ctal . Post-ictal :
- :
.

(.(Guppta,etal.,1984


.
.
.(Lechtenberg, 1985).
:
-1 Affective Disorders Apathy
. Apprehension
.
)
Lennox,1960. Lishman, 1978,Fenton,1981a, Strans,1982, 1982
. (Lechtenberg,1985. Robrtson ,1988
-2 Perceptual Disoreders
Olfactory
- .... - .
Macropsia
or Micropsia ) Flor,1972 ,Bannister, 1978,
. ( Schomer, 1983
-3 Thought Disorders
Ideas of reference )
. ( Flor,1972 ,Lechlan,1980 ,Herman,1980, Lechtenberg,1985
-4 deja vu jamais vu

- -
Blaumer,1975 ).
. ( Degladow,1983
-5 Depersonalization
.
Derealization
Passivity )
. ( Blaumer,1975, Herman,1980, Fenton,1982b 1982
-6 Autonomic Nervous
System - -
.
.
)
Lennox,1960, Hecker,1972, Hebb,etal., 1972, Herman, etal., 1980,
( .Remilard,etal.,1981, Schomer,1983
-7 Sensory Symptoms Numbiness Parathesia
) Flor, 1972
. (,Kaufman,1981,Neppe,1981,Schomer,eral., 1983
-8

7

) Lennox,1960, 1980
. ( Flor,etal.,1972,Fenton,1972,Fenton,1981a
-9 Dysartheria
.
Bannister, 1978 ), Taylor, 1981, Kaufman,
.(1981,Neppe,1981,Guppta,1983
- :

) . ( Lechtenberg, 1985
:
-1
.
) . ( Bannister , 1978, Blaumer,1975, Lechtenberg,1985 1980
-2 _ _
Lechtenberg , ).
1985,,Herman,1980, Ficol ,1984
-3 Al-Garem,1984,).
.( Bannister,1978,Fenton,1981b , Schomer,1985
-4 Fugue State
. ) Dreamy Like State
. ( Fenton,1981b, Neppe,1981, Lechtenberg,1985 1980
- 5
)
. ( Herman,1980, Neppe,1981, Lechtenberg,1985
-6
. ( Walton,1978,Taylor, 1981,Kaufman,1981) .
-7
) . ( Blaumer,1975, Herman , 1980, Gunn,1982
-8 .(Lechtenberg, 1985) .
.

Psychomotor Status
) ( Fenton, 1981b
. ) ( Engel, 1978
.
:
-1 .
- 2 .
-3 .
-4
.
8

 - -
) .
. ( Fenton ,1981a, Engel,1981, Lechtenberg,1985


.

.
- :
10 - 2
.
Disorientation
.
.
) . ( Blaumer,1975, Gunn,1982

.

Flor,etal.,1972, ) .
. ( Waxman,etal.,1975, Herman,1980,Fenton,1981a, Kaufman,1981
: :

.

)
( .Ictal E.E.G
. -
- . ( Lida,etal.1985, Rowan,etal.,1988) .

) ( .Inter-ictal E.E.G
) .
. ( Guppta,etal.,1983, Rowan , etal.,1988

. ) Ajmene,
(etal., 1970
% 55
. Salisky, etal.,
1987
% 50
% 84 % 92 .
9

 :
-1 % 50 - -
.
-2


.
-3 -
-
.
-4
- -




.


.
: : :

- -
.

-
- Confirmatory
. Diagnostic





.

Neuropsychology
.


10


.

-
- .
.
: :


. :
-1
.
-2

.
.
Subjective symptoms
Objective
.


.
-3
.


.
-4 70
.
188 87 ) ( %46.28 101 )
. ( %53.72 ) 37 ( % 19.68
) 30 ( % 15.43 ) 39 20.74
( % ) 29 ( % 15.43 )
53 .( % 28.19 28.33
. 8.11
-5 90
30 3 ,
. 30 30
.
-6
) 6 5 5 ( .

11

 )(
)( )( )(.
: :
:
-1 :

) ( . :
- :
90 30 3 - -

10
:
-1
.
-2 .
-3
.
30
30 .% 100 - 75
. % 100 - 85
- :


- -
) .
1980 .323

:
-1 -
-
. 114
93 .% 81.58
-2

.
38 32
. % 84.21
-2 :

.
12

 - :

64
) 52 (
.
. . 0.93
- :
) 52(

.
. 0.81 -
) .
1971 .( 421 . 0.90
: :
:
-1 .
-2
.
: :

. -
-



.


.
.
, .
.
30 30
. :
-1 : . 25 19 13 7 1
-2 : 26 20 14 8 2
-3 : . 27 21 15 9 3
-4 : . 28 22 16 10 4
-5 : . 29 23 17 11 5
-6 : . 30 24 18 12 6

13

 5
. 4 )(
)( ) ( ) ( . .
1 2 3
. 90 -.
: :
) ( 123
) (
) ( 90 -
. 45 .
: :

.
)(
.



. ) . . (
. :
""
) (
. "" .
: : 6



. 160
50 ) ( % 31.25 110 )( % 86.75

Principal Components H. Hoteling
Eigen Value
.
Varimax 3 ,
.0.3
:
-1 -7 6
.

14

 .
.
-2 ,
0.01 .
-3
. 0.01
-4 0.01
.
-5
. 0.01
-6
.
.
3 . :
-1 3
) (0.986 ) (0.802
) (0.696 ) .(0.689
.
-2
) (0.708 )(0.634 -
) .(0.553 - .
.
-3 :
) (0.571 ) (0.497 -
) (0.432 ) .(0.367
.
-4 % 71.1 .


- -
) ( .
:
-1 3
. % 71.1
-2
.
) (
)
1971 . ( 641 640
15

 3
.
.
-3 2.73 % 39.1

. 4
: ) (0.879 ) (0.850
) (0.818 ) .(0.518
0.879 - 0.518

.
.
-4 1.24 % 17.7
3 :
) (0.854 ) (0.544
) . (0.452
.
-5 1.002 % 14.4 .
)
(0.837 ) .(0.570 -
.
: :


.

3


.
) (
.


( Schomer,1983 ) .


. ( Bannister,1978, Herman ,etal.,1980a ) .


16

 .... .
)Babb,etal.,1972,Ramilard,etal.,1981,
. Schomer,1983

..... .

.
) (

,
.
Blaumer, 1975, Mayeux,etal.,1980. Degladow, ).
(1983, Al Gatem,1984

3



) (
.
- -


.


.



.
.

-1 ) :(1980 .
.
-2 ) :(1982 .
.
-3 ) :(1980 .
.
17

 . :(1985) -4
.
. :(1971) -5
.
. : (1976) -6
.
Ajmene- Marasance, Zivin (1970): Factors related to the occurrence of -7
typical paroxysmal abnormalities in E.E.G. record of epileptic patients.
. Epilepsia , 11:362-368
'
Al Garem,O.(1984): Al Garem s clear neurology for medical students . Cairo -8
. , Dar El-Maaref
. Babb,R.,Eckman,P. (1972): Abdominal Epilepsy, J.A.M.A ,222 :265 -9
Bannister,R. (1978): Brain's clinical neurology . Oxford University
-10
.Press
Blaumer,D.. (1975): Temporal Lobe Epilepsy and its psychiatric
-11
significance. In : Benson,D.,Blaumer,D. (eds.) Psychiatric Aspects of
.Neurological Diseases . New York , Grune & Starton
Booker,H.(1975): Management of difficult patients with complex partial
-12
. epilepsy . Advances In Neurology , New York , Raven Press, Vol. 11: 369
Degladow,E.,Trieman,D.,etal. (1984): The treatable Epilepsies (part 2).
-13
.New England J. Medicine, 308 (26): 1576-1584
Dreifuss,F.(1975): Differential diagnosis of complex partial seizures .
-14
.IN: advances of Neurology , New York , Raven Press , Vol. 11
Engel,J. Luding,B.(1978): Prolonged Partial Complex Status
-15
Epilepticus: E.E.G. and Behavioral Observations. Neurology, 28 (9): 863. 869
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.64
a : Personality and behavior disorders in adults . In(1981) ---------------17
: Epilepsy and Psychiatry , Renylod,R.,Trimble,E. (eds.) Edinburgh , Churchill
. Livingston
b : Psychiatric Disorders of Epilepsy . In:(1981) ----------------18
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. Churchill , Livingston
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-19
. Epilepsia, 25: 669 - 620
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-20
. in epilepsy : specific or non specific ? . Epilepsia , 13 : 774
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-21
treatment of epilepsy. In: Handbook of electroencephalography and clinical
. neurology. Gastaut,H. (ed.) , Elservier , Amsterdam , Vol. 13
Greenberg,D.,Hochberg,F.,Murray,G. (1984): The theme of death in
-22
complex partial seizures . Am.J. Psychiatry,141.12:1587-1589
Gunn,J.(1982): Violence and epilepsy . New Engl.J.Medicine,306 :298
-23
. -299
Guppta,A.,Jeavons,P.,Hughes,R. (1983): Aura in temporal lobe
-24
epilepsy : clinical and electroencephalic correalation . J. Neurology &
.Neurosurgery & Psychiatry. 46: 1079-1083

18

Hecker,A.,Anderman,F. (1972): Spitting automatism in temporal lobe

-25
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-26
ictal fear : examples of sensory limbic hyperconnection . Archives of
.Neurology, 37 :6678-6680
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-27
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epileptic patients. Folia Psychiatrica et Neurologica Japonica, 39:43058 29Kaufman,D.(1981): Partial complex seizures . In: Clinical Neurology for
. psychiatrics, Kaufman,D.(ed.) . London , Grun, Starton
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. Comp., Boston
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-31
.language impairment in temporal lobe epilepsy. Neuruology , 30 :120
McLachlan,R., Blume,W. (1980): Isolated fear in complex partial status
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.epilepticus . Annual Neurology, 8:639
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-33
Affrica Medical J. 60: 902 - 907
b: Is deja vu a symptom of temporal lobe(1981) ---------------34
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. Organization, Cairo
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. Churchill Livingston , Edinburgh , London
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Jasper,H. (1954): Epilepsy and functional anatomy of ,--------------38
. human brain . Little Brown, Boston
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-39
.phenomenon in complex partial seizure . Neurology, 31: 117
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reconsidered . In : Recent advances in neurology . Pedley, T., Meldrum, B.
. (eds.) Vol.4. Churchill Livingston, Edinburgh , London
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. 347 - 348

19

Stranss ,E., Risser, A. (1982) : Fear responses in patients with epilepsy .

-47
. Archives Neurology, 39 (10( : 626-630
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-49
. London
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-50
. temporal lobe epilepsy . Archives Gen. Psychiatry, 32 : 1580 - 1586

) . .(

.


)(1994

: ) ( - ( ( : : : : )
(
. .

1
2

3
4
5
6
7
8
9
1

20

0
1
1
1
2
1
3
1
4
1
5
1
6
1
7
1
8
1
9
2
0
2
1
2
2
2
3
2
4
2
5
2
6
2
7
2
8
2
9
3
0

=
21

 =
=

22