Personality and epilepsy: New evidence for a relationship? A review

A causal relationship between epilepsy and changes in personality has been postulated by several authors. Further, a specific behavioral syndrome of temporal lobe epilepsy has been described in a number of studies. This survey of the literature, including studies with Minnesota Multiphasic Personality Inventory (MMPI), the Bear-Fedio Inventory, and psychiatric clinical assessments, points to a raised prevalence of emotional and psychological problems in patients with epilepsy in general and temporal lobe epilepsy in specific. However, no consistent picture of the phenomenology of personality changes emerge from the studies. The presence of a specific behavioral syndrome of temporal lobe epilepsy is not supported from the studies surveyed, but several case reports suggest a relationship between pronounced interest in philosophical/religious matters, hypergraphia, and altered sexuality, often hyposexuality. The majority of studies, though, include patients seen in hospital settings and, in some studies, patients undergoing temporal lobectomy, thus a rather severely affected population hardly representative for an “average” epileptic population. Further, besides the presence of an epileptogenic process, the influence of a number of factors (e.g., anticonvulsant medication, heredity, social factors, age at onset, and duration of illness) is yet to be determined.