Forced normalization

I love the way this completely startling fact is dropped into a sentence about one of the pioneers of German neurology:

The work of Wilhelm Griesinger (1817-1868) (whose father was murdered by the family’s insane piano teacher) marks the birth of neurology in Germany.

The excerpt is from a book I’m reading called Forced Normalization (ISBN 1871816378) by Trimble and Schmitz which is nothing to do with forcing people to be normal, but tackles the fascinating phenomenon where some people become psychotic as soon as their epilepsy is successfully treated (their EEG is ‘normalised’).

The person most associated with this concept is Heinrich Landolt, and the book contains a translation of his key 1958 paper in which he reported a case series of people with epilepsy. It contains this interesting conclusion:

Thus, these cases reveal an unmistakable correlation between the course of the psychotic process and the changes in the EEG, in the the paroxysmal focus which is active before and after the twilight state dissolves during this twilight state, and often so completely that the record is normalized. In other words, and putting it more crudely, there would seem to be epileptics who must have pathological EEG in order to be mentally sane…

Interestingly, this phenomenon may have been the basis of Meduna’s false belief that epilepsy and psychosis don’t occur together, leading him to try inducing seizures as a treatment. This was the birth of an idea that was later developed into electroconvulsive therapy (ECT).

This is certainly not the most common pattern, however, as for the majority of people, epilepsy makes psychosis slightly more likely to occur.

Link to more info on ‘forced normalization’.

1 thought on “Forced normalization”

  1. If I may ask why were you reading this book? Do you just research or do personally suffer from epilepsy? I personally find the brain fascinating even with all its quirks?!!

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