EPILEPTIC PSYCHOSIS. In the older descriptive neurological concepts, this indicated a mental complex accompanying epilepsy. It was characterized by a certain degree of men tal deterioration, as shown in the impairment of intellect and memory, by impulsiveness, men tal irritability, loss of moral sense and partial or complete loss of productiveness. It is also accompanied by periodic disturbances, transitory attacks of anger, dream-states or automatic phenomena. Many patents with epileptic at tacks do not develop such severe psychoses as to require certification and sequestration, but the mental deterioration may appear at almost any period following the onset of the epilepsy. In many chronic epileptic states there is pronounced weakness, mentally, morally and emotionally. One's sense of one's surroundings is usually preserved, and consciousness may be clear save during the dream-states or automatic periods. Comprehension is usually not markedly im paired, but the field of attention is diminished and easily diverted. Hallucinations are infre quent, illusions are common during an attack or following a grand mal seizure, and delusions are transitory, being found usually only in the dream-states. Morbid and sudden impulses are quite frequent, sometimes approaching distinct nerve-storms, during which suicidal and homi cidal attacks may occur. The conduct other
wise is usually orderly, and the ordinary rules of propriety are observed. There is greatly diminished capacity for work in practically all epileptics. The subject of a severe epileptic psychosis is one deserving wide recognition as there are unquestionably a number of phenom ena termed °psychical* epilepsy that need recog nition by specialists. In some of these attacks the patients are confused. They move in a mechanical or automatic manner. They wan der aimlessly about, recognizing no one, al though sometimes answering incoherently when addressed. Occasionally they exhibit symptoms of excitement, at other times depression, and not infrequently they may set fire to their beds or furniture, commit theft, assaults, homicides, expose their persons and otherwise conduct themselves in an irrelevant and insane manner. Treatment is extremely difficult in advanced stages. While younger psychoanalysis and careful endocrinopathic study offer the best chances for modifying the conditions which tend to bring about the epileptic deterioration. The patient should be kept in a sanatorium or asylum. See EPILEPSY.