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Behavioral Symptoms in Temporal Lobe Epilepsy

Edward K. Silberman, MD
Arch Gen Psychiatry. 1983;40(4):468. doi:10.1001/archpsyc.1983.01790040122021.
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To the Editor.—  The recent article bv Mungas (Archives 1982;39:108-111) provided useful data about pathologic personality traits in psychiatric and neurologic conditions, but contained a serious misconception about what kind of specificity has been claimed for the Bear-Fedio behavioral syndrome.1 The author compared temporal lobe epileptics with patients having psychiatric and nonepileptic neuropsychiatric illnesses and found that high scores on the Bear-Fedio inventory correlated with presence of psychiatric disorder in any of the groups, but not with presence of epilepsy. He concluded that the syndrome has no specific relation to epilepsy, but represents "nonspecific psychopathology."Bear and Fedio, however, make no claim that the traits in their inventory are found exclusively in epileptic patients, but only that symptom profiles that aptly describe psychiatric illnesses are poorly fitted to the interictal behavior patterns of epileptics. Surely, clinicians would not be surprised to find the Bear-Fedio traits (eg, aggression, obsessionalism, sadness, and dependency) occurring in


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