A shy serial murderer, a social loner with past head injuries and previous petit mal seizures, surrendered voluntarily after 25 years. All his homicides had been unplanned, motiveless, and committed with flat affect and during a fleeting psychosis. Both onset and cessation of the symptomatology were sudden and had progressed in three phases, implicating seizures. After recognizing the fatal meaning of his “premonition signs” (his visual aura), he was able to flee immediately and permanently from two potential further victims. His flight had also removed the impact of his individualized external trigger stimuli (demands for closeness), which previously had revived past similar stresses. Because such external stimuli are necessary for seizure kindling, the apparent seizureaborting effect of their removed impact supports a hypothesis of seizure kindling. Previously, 16 similar homicidal cases had been proposed as limbic psychotic trigger reaction. Furthermore, the volitional abortion of a seizure was not followed by an alternative psychosis or forced normalization.
American Psychiatric Association. (1994). Diagnotic and statistical manual of mental disorders(4th ed.). Washington, DC: Author.
2.
Arnold, S. E. (1997). The medial temporal lobe in schizophrenia. In S. Salloway, P. Malloy, & J. L. Cummings (Eds.), The neuro-psychiatry of limbic and subcortical disorders(pp. 155-166). Washington, DC: American Psychiatric Press.
3.
Damasio, A. (1999). The feeling of what happens: Body and emotion in the making of consciousness. New York: Harcourt Brace.
4.
Descartes, R. (1911). Passions of the soul. In E. Haldane& G. Ross (Eds.), Philosophical works of Descartes (Vol. 1). New York: Cambridge University Press. (Original work published 1649)
5.
Devinsky, O., Kelley, K., Port, R. R.,& Theodore, W. H. (1988). Clinical and electroencephalic features of simple partial seizures. Neurology, 38, 1347-1352.
6.
Geschwind, N. (1984). Clinician scientists. Science, 224, 243-243.
7.
Goddard, G. V. (1967). Development of epileptic seizures through brain stimulation at low intensity. Nature, 214, 1020-1021.
8.
Goddard, G. V., & McIntyre, D. C. (1986). Some properties of a lasting epileptogenic trace kindled by repeated electrical stimulation of the amygdala in mammals. In. B. K. Doane& K. E. Livingston (Eds.), The limbic system: Functional organization and clinical disorders(pp. 95-105). New York: Raven.
9.
Kaada, B. (1967). Brain mechanisms and social patterns. In C. D. Clemente& D. B. Lindsley (Eds.), Aggression and defense: Neural mechanisms and social patterns(Vol. 5, pp. 95-133). Berkeley: University of California Press.
10.
Krishnamoorthy, E. S.,& Trimble, M. R. (1998). Mechanisms of forced normalization. In M. R. Trimble& B. Schmitz (Eds.), Forced normalization and alternative psychoses of epilepsy(pp. 193-208). Bristol, PA: Wrightson Biomedical.
11.
Landolt, H. (1998). Serial electroencephalographic investigations during psychotic episodes in epileptic patients and during schizophrenic attacks. In M. R. Trimble,& B. Schmitz (Eds.), Forced normalization and alternative psychoses of epilepsy(pp. 25-48). Bristol, PA: Wrightson Biomedical. (Original work published 1951)
12.
MacLean, P. D. (1990). The triune brain in evolution. New York: Plenum.
13.
Pontius, A. A. (1981). Stimuli triggering violence in psychoses. Journal Forensic Sciences, 26, 123-128.
14.
Pontius, A. A. (1987). Psychotic trigger reaction: Neuro-psychiatric and neuro-biological (limbic?) aspects of homicide, reflecting on normal action. Integrative Psychiatry, 5, 116-139.
15.
Pontius, A. A. (1993a). Neuroethological aspects of certain limbic seizure-like dysfunctions: Exemplified by limbic psychotic trigger reaction (motiveless homicide with intact memory). Integrative Psychiatry, 9, 151-167.
16.
Pontius, A. A. (1993b). Overwhelming rememberance of things past: Proust portrays limbic kindling by external stimulus. Psychological Reports, 73, 612-621.
17.
Pontius, A. A. (1996). Forensic significance of the limbic psychotic trigger reaction. Bulletin of the American Academy of Psychiatry and Law, 24, 125-134.
18.
Pontius, A. A. (1997). Homicide linked to repetitive moderate stresses kindling limbic seizures in 14 cases of limbic psychotic trigger reaction. Aggression and Violent Behavior, 2, 125-141.
19.
Pontius, A. A. (1999). Motiveless firesetting implicating partial seizure kindling by reviving memories of fires in “limbic psychotic trigger reaction.”Perceptual and Motor Skills, 88, 970-982.
20.
Pontius, A. A. (2000). Comparison between two opposite homicidal syndromes (Syndrome E vs. limbic psychotic trigger reaction). Aggression and Violent Behavior, 5, 423-427.
21.
Pontius, A. A. (2001a). Two bankrobbers with “antisocial” and “schizoid-avoidant” personality disorders, comorbid with partial seizures: Temporal lobe epilepsy and limbic psychotic trigger reaction. Journal of Developmental and Physical Disabilities, 13, 191-197.
22.
Pontius, A. A. (2001b). Homicides with partial limbic seizures: Is chemical kindling the culprit?International Journal of Offender Therapy and Comparative Criminology, 45, 515-527.
23.
Pontius, A. A. (in press). From volitional action to automatized homicide: Changing levels of consciousness during partial seizures. Aggression & Violent Behavior.
24.
Pontius, A. A.,& LeMay, M. J. (in press). Aggression in temporal lobe epilepsy and “limbic psychotic trigger reaction” implicating vagus stimulation of hippocampus/amygdala (in naso-pharyngeal infections) with sinus pathology on MRIs. Aggression & Violent Behavior.
25.
Tellenbach, H. (1998). Epilepsy as a seizure disorder and as a psychosis: On alternative psychoses of a paranoid type with “forced normalization” (Landolt) of the electroencephalogram of epileptics. In M. R. Trimble& B. Schmitz (Eds.), Forcednormalization and alternative psychoses of epilepsy(pp. 49-67). Bristol, PA: Wrightson Biomedical.
26.
Trimble, M. R., & Schmitz, B. (Eds.). (1998). Forced normalization and alternative psychoses of epilepsy. Bristol, PA: Wrightson Biomedical.
27.
Van Hoesen, G. W. (1997). Ventromedial temporal lobe anatomy, with comments on Alzheimer's disease and temporal injury. In S. Salloway, P. Malloy, & J. L. Cummings (Eds.), The neuropsychiatry of limbic and subcortical disorders(pp. 19-29). Washington, DC: American Psychiatric Press.
28.
Wada, J. A. (1978). The clinical relevance of kindling: Species, brain sites and seizure susceptibility. In K. E. Livingston& O. Hornykiewicz (Eds.), Limbic mechanisms, the continuing evolution of the limbic system concept(pp. 369-388). New York: Plenum.
