MMPI profiles of patients who endorse multiple partial seizure symptoms.

Abstract

This investigation was concerned with the MMPI profiles of 40 patients who reported multiple symptoms of partial seizure-like phenomena and had abnormal EEGs. The majority of this sample was presumed to have longstanding treatment-resistant psychiatric illnesses. Grossly abnormal MMPl profiles with multiple elevations were frequently observed, with 65% having significant elevations on at least six of the ten clinical scales. The mean group profile had seven significant scale elevations (i.e.,T-score >69). Of 38 patients whose medical records were available for review, all but one patient had a history of some form of cerebral trauma, 66% had obtained four or more psychiatric diagnoses, and 45% had been tried unsuccessfully onfour or more psychotropic medications. More than 80% of patients tested failed a simple dichotic word listening task, providing additional validity for the view that their symptoms were associated with cerebral dysfunction. Thirteen of 16 patients subsequently treated with open trials of carbamazepine (Tegretol) exhibited clinical improvement which was often associated with less deviant MMP 1 profiles at follow-up. Findings suggest that psychiatric patients with grossly elevated MMPI profiles should be routinely screened for multiple partial seizure-like symptoms.

Subjective Improvement following Treatment with Carbamazepin (Tegretol) for a Subpopulation of Patients with Traumatic Brain Injuries

“…The grossly elevated MMPI profiles of patients who displayed elevated signs for the Epileptic Spectrum Disorder and deficient dichotic word listening were similar to the patterns reported by Roberts, et al (1988). The selfreports of marked improvement with Tegretol after no improvement with traditional antidepressants or worsening of symptoms with antipsychotic drugs also supports the results of Roberts' research team.…”

“…Such results suggc5r that many of the debilicating symptoms that persist for months to years after ;I traumatic brain injury may be electrical in nature rather than due to "psychological responses" and might be treatable by appropriate dosages of carbamazepine or other, e.g., Gabapentin (Neurontin) antiepilepuc compounds. Roberts, Paulsen, Marchman, and Varney (1988) reported that 13 of the 16 patients who were treated with the antiepileptic drug carbamazepine (Tegretol), a derivative of iminodibenzyl related structurally to the antidepressant irnipramine (Leppk, 1990), exhibited marked chical and psychometric improvement. These patients who had sustained brain traumas had been diagnosed for years with multiple psychiatric difficulties yet had not responded to traditional medications for these diagnostic categories.…”

“…The present study reports the retrospective experiences of patients following treatment with Tegretol more than one year after a closed-head inju-ry associated with motor vehicle incidents. All patients (N= 19; 11 men, 8 women) who displayed scores that were more than 2.5 standard deviations below the mean for a dichotic word-listening task (Persinger, 1995;Persinger & fichards, 1995) and 5.0 standard deviations above the mean for the Epileptic Spectrum Disorder Inventory (Roberts, et al, 1988) were recommended for treatment with Tegretol beginning with a very low dosage of 100 mg/day for the first week and then increasing in 100-mg/day increments per week until the lower dosages recommended for verified epileptic patients had been approached or the symptoms attenuated. Of the 19 patients, 14 and their physicians complied.…”

Complex partial epileptic signs as a continuum from normals to epileptics: Normative data and clinical populations

“…Several groups of researchers (e.g., Livingston & Escobar, 1971;Persinger & Makarec, 1987; Roberts, Varney, Hulbert, Paulsen, Richardson, Springer, Smith-Shepard, Swan, Legrand, Harvey, & Strichen, 1990), using different methods and perspectives, have suggested that the behaviors and experiences of patients who display or who are inferred to display electrical lesions within the hippocampal-amygdaloid regions are extreme examples of the normal population. Roberts and associates (Roberts, Paulsen, Marchman, & Varney, 1988; Roberts, Varney, Hulbert, et al, 1990; Roberts, Varney, Paulsen, & Richardson, 1990) have shown repeatedly that patients who exhibit quantitative increases in complex partial epileptic-like signs also display dichotic listening deficits and multiple elevations on the MMPI. Both the dichotic listening and MMPI scores improve (Springer, Garvey, Varney, & Roberts, 1991) after treatment with the anticonvulsant carbamazepine (Tegretol).…”

“…Roberts and associates (Roberts, Paulsen, Marchman, & Varney, 1988;Roberts, Varney, Hulbert, et al, 1990;Roberts, Varney, Paulsen, & Richardson, 1990) have shown repeatedly that patients who exhibit quantitative increases in complex partial epileptic-like signs also display dichotic listening deficits and multiple elevations on the MMPI. Both the dichotic listening and MMPI scores improve (Springer, Garvey, Varney, & Roberts, 1991) after treatment with the anticonvulsant carbamazepine (Tegretol).…”