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Related Concept Videos

Psychosurgery01:30

Psychosurgery

Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...

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Related Experiment Video

Updated: May 21, 2026

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
09:53

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Published on: July 5, 2021

'Forced normalisation' in the neurosurgical era.

Lokesh Shahani1

  • 1Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois, UK. lokesh83@hotmail.com

BMJ Case Reports
|June 12, 2012
PubMed
Summary

This case study highlights the phenomenon of forced normalization in epilepsy, where improved seizure control worsened behavioral disorders. A young man with temporal lobe epilepsy experienced a significant increase in impulse control issues after surgery.

Area of Science:

  • Neuroscience
  • Clinical Psychiatry
  • Epileptology

Background:

  • Epilepsy and behavioral disorders share a known correlation.
  • Forced normalization describes behavioral worsening post-seizure control.
  • Anti-epileptic treatments can sometimes complicate and worsen behavioral disorders.

Observation:

  • A young man with a 12-year history of temporal lobe epilepsy and poor seizure control presented with a comorbid impulse control disorder.
  • MRI revealed left mesial temporal sclerosis, and intracranial EEG pinpointed seizure foci in the left medial temporal lobe.
  • The patient underwent a left temporal lobectomy for seizure control, achieving only partial success.

Findings:

  • Post-surgery, the patient's impulse control disorder significantly worsened.

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  • This behavioral deterioration led to physical altercations and subsequent incarceration.
  • The case illustrates a potential adverse outcome of epilepsy surgery where partial seizure control exacerbates behavioral issues.

    • Implications:

    • This case underscores the complex interplay between seizure control and behavioral health in epilepsy management.
    • It highlights the need for careful monitoring of behavioral changes following epilepsy surgery.
    • Further research into the mechanisms of forced normalization is crucial for optimizing treatment strategies.