Emergence of complex partial epilepsy-like experiences following closed head injuries: Personality variables and neuropsychological profiles

To pursue Richard Roberts’ epileptic spectrum disorder (ESD) and the emergence of complex partial epilepsy-like experiences, items and total scores for the ESD Inventory were examined for 185 patients who had sustained mechanical impacts (and were diagnosed with or without neuropsychological impairment) and a reference group (n = 68) of university students. Results from neuropsychological, personality, neurological screening, and interview data supported the role of temporal lobe origins for these experiences. The incidences of these experiences were sufficient to adversely affect adaptation and to produce psychiatric profiles. Although only 70% of the patients who were impaired versus not impaired could be differentiated by items from the ESD Inventory, > 95% of the patients with scores > 100 on the ESD Inventory displayed abnormal scores on more than four Minnesota Multiphasic Personality Inventory scales. These results support Roberts’ ESD concept and strongly suggest that persistent, subclinical occurrence of these experiences could be the cause or major correlate of neuropsychological impairment for these patients.

► The incidence of partial complex epilepsy-like experiences is increased in different populations.
► Skull impact without loss of consciousness increases the incidence of these experiences.
► Neuropsychological test results and subjective experiences support a temporal lobe origin.
► Psychiatric (MMPI) profiles of patients with an increased frequency of complex partial epilepsy-like experiences are consistent with a history of head impact.
► The most common symptoms are sudden confusion, trouble thinking, and memory blanks.