Saturday, June 02, 2012

Compulsion to write caused by seizure, whether at work or at leisure

Hypergraphia is a compulsive or overwhelming urge to write, often associated with temporal lobe epilepsy. Influential behavioral neurologist Norman Geschwind included hypergraphia as one of the personality changes that can be observed in persons with temporal lobe epilepsy.

An unusual example of hypergraphia was observed by Dr. Mario F. Mendez, who reported the unique case of a 58 year old man who felt utterly compelled to write poetry (Mendez, 2005). The patient reported no previous history of being a poet until the age of 53, when he felt the urge to write in rhyme. He said that words are "continuously rhyming in [my] head" and felt the need to write them down and show them to other people. He didn't speak in verse, nor did he write nonrhyming prose or read others' poetry.

Thus, his condition was a very specific hypergraphia for poetry. The rhyming condition coincided with the onset of other behavioral symptoms, namely irritability and anger. Shortly thereafter he began to have partial complex seizures, which typically have foci (or origins) in the medial temporal lobes.
His seizures manifested as a sensation "rising" in his stomach followed by a brief alteration of consciousness. Seizure control with phenytoin and gabapentin ameliorated his irritability and anger but did not diminish his constant need to write in rhyme. ...

The patient underwent a repeat evaluation. On examination, he was circumstantial and somewhat viscous. He repeatedly emphasized the significance of his symptom of poetry writing, and continually responded in written poetry. Language, mental status, and neurological examinations were otherwise normal except for a slightly broad-based and unsteady gait. He had right temporal spikes on electroencephalograms and small strokes in the right thalamus and the right cerebellum on neuroimaging.

However, Mendez (2005) did not think the small right hemisphere strokes caused the patient's hypergraphia. The author was also skeptical that ongoing subthreshold ictal activity was solely responsible, because the seizures were well-controlled yet the poetry continued. Another possible explanation was related to persistent hypofunctioning in the right hemisphere, which could lead to disinhibition or "unmasking" of poetic abilities in the left hemisphere.1 This hypothesis assumes that the right temporal lobe maintains tonic control over neural activity in the left hemisphere, so we don't all turn into Joyce Kilmer.


A notoriously hypergraphic writer of poetry and prose was Arthur Crew Inman (1895-1963), who will be the subject of Hypergraphia, a forthcoming film starring John Hurt.

Arthur Crew Inman was a reclusive and unsuccessful poet whose 17-million word diary, extending from 1919 to 1963, provides a panoramic record of people, events, and observations from more than four decades of the twentieth century.


1 Most people are left hemisphere dominant for rhyme generation (Krach & Hartje, 2006).


Mendez, M. (2005). Hypergraphia for Poetry in an Epileptic Patient Journal of Neuropsychiatry, 17 (4), 560-561. DOI: 10.1176/appi.neuropsych.17.4.560

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At June 03, 2012 10:21 AM, Blogger Right Mind Matters said...

I subscribed to your blog last night after googling area 25. I was trying to find out exactly where it was. I found your post very helpful. This morning i got your post about hypergraphia, with a reference to an obscure scientific paper on rhyme in the left hemisphere that I have used in my book in progress on poets who access dissociative language through atypical lateralization and the aftermath of childhood trauma.. Julie Kane, whose article "Poetry as Right Hemispheric Language" first put me on to the left rhyming function and I was stunned to see someone else writing about this. Now, I learn that there is a movie coming out about a particular person who suffered hypergraphia. Alice Flaherty also wrote convincingly about hypergraphia in her book, The Midnight Disease. She says that Vincent van Gogh had a version of it in his compulsion to paint and to write letters every day to his brother Theo. The movie looks fabulous. I can't wait to see it as well as more of your posts!

At July 06, 2012 9:19 PM, Blogger snipet said...

Trying to find data on infusions as new treatment for Mental Disorders, I found this Blog. I can identify well to the feelings of an 'Aura', as cited by Dr. Mendez, whenever I have what I thought were "anxiety-attacks". I also suffer from obsessional-OCD. My family has a history of 'Seizure' activity. This makes me want to explore that possibility more-so, especially now that I have health insurance in the USA.


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