Subtypes of limbic system dysfunction evoking homicide in limbic (?) Psychotic trigger reaction and temporal lobe epilepsy--evolutionary constraints

Neuropsychiatric Update of the Crime “Profile” and “Signature” in Single or Serial Homicides: Rule out Limbic Psychotic Trigger Reaction1

A neuropsychiatric and -psychological update of the crime “profile” and “signature” is a necessary addition to the traditional sociopsychological model likely to miss limbic system dysfunctioning. Thus, occurrence of a brief (c. 20 minutes) limbic seizure has been proposed based on behaviors of 12 white male homicidal loners, who showed a dozen symptoms and signs: Limbic Psychotic Trigger Reaction. Readily overlooked can be (a) a transient psychosis (hallucinations and/or delusions), (b) autonomic hyperactivation (e.g., loss of bladder control, nausea, ejaculation), (c) motiveless, out-of-character, unplanned, and well-remembered homicidal acts, (d) committed with a flat affect (not emotionally or impulsively provoked), (e) typically involving a stranger who happened to provide an objectively harmless and only subjectively important stimulus. (f) Such an individualized stimulus triggered the memory revival of mild to moderate but repeatedly experienced hurts. Such a specific sequence of events implicates the specific mechanism of limbic seizure, “kindling,” which does not necessarily involve motor convulsions. Repetition of such limbic episodes with “criminal acts” is conceivable under specific circumstances including cases in which the triggering stimulus is associated with pleasurable delusions (e.g., of grandiose power or wealth) or constitutes a specific aspect of a basic drive motive. For example, eating or sexual activities might be planned but degenerate into a limbic episode with a specific core symptomatology.

Motiveless firesetting: implicating partial limbic seizure kindling by revived memories of fires in "Limbic Psychotic Trigger Reaction"

23 unselected juvenile firesetters (M age 12.0 yr.) consisted of seven with schizophrenia, three with organic mental disorder, six with posttraumatic stress disorder, two with severe mental retardation, and two with conduct disorders. Three previously nondestructive boys (M age 11.0 yr.), all of them loners, did not fit such traditional diagnoses. Their fleeting (c. 20 min.) symptoms included flat affect, autonomic arousal, and delusions or hallucinations. It appeared that their motiveless, unplanned acts were each preceded by a chance encounter with an individualized stimulus which revived the three boys' repeatedly ruminated memories of intermittently experienced merely moderate stresses associated with fire, smoke, or matches. Such a sequence of events is characteristic of seizure kindling. One boy's abnormal EEG was congruent with seizures in the temporal lobe area, which includes the amygdala, i.e., that part of the limbic system particularly susceptible to seizure kindling. The three boys' consistent symptomatology was very similar to that reported for 17 men with bizarre homicidal acts implicating a kindled partial seizure called "Limbic Psychotic Trigger Reaction." In primates, too, similar partial nonconvulsive "behavioral seizures" with psychosis-like symptoms can be elicited through experiential kindling.

Overwhelming remembrance of things past: Proust portrays limbic kindling by external stimulus--literary genius can presage neurobiological patterns of puzzling behavior

Proust detailed inexplicable behavior long before the neurobiologists Goddard and McIntyre in 1972 demonstrated that intermittent repetition of harmless stimuli can cause "kindling" of a seizure (with or without motor convulsions). Such brief seizures can occur especially in the evolutionarily old limbic system which mediates basic drives, their concomitant emotions, and certain aspects of memory. It appears that in humans the influence of specific external stimuli that revive the memory of repeated past experiences may "kindle" a transient episode of limbic overactivation. Thereupon the normal balance between the limbic and frontal lobe systems is disturbed (for a few minutes) as are normal human decision making and control of action. Linked with such a transient frontolimbic imbalance is out-of-character behavior, psychosis (hallucinations or delusions), autonomic activation, and severe distortion of affect and of action, culminating in extreme cases in a "Limbic Psychotic Trigger Reaction," as proposed by Pontius in 1981, in motiveless homicidal acts with mostly preserved consciousness and memory for the acts.

Infanticide in Limbic (?) Psychotic Trigger Reaction in a man with jacksonian and petit mal (?) seizures: "kindling" by traumatic experiences

A tenth case (a subtype of complex partial seizures) is proposed as a Limbic (?) Psychotic Trigger Reaction. Upon crying, an infant girl was hit fatally by her devoted father while he was off anticonvulsants prescribed for Jacksonian and petit mal (?) seizures with "porencephalic cyst involving motor cortex and limbic system." Crying revived traumatic memories of frequently repeated ("kindling") experiences of his mother crying when hit by his father, in turn sometimes hit by patient while helping the mother. Hitting also had been helpful (cognitive mismatch between helpful and harmful hitting) during the victim's accidental choking 11 days earlier. This had occurred on the same day his distant mother died. Two days later he attempted suicide with anticonvulsants. Symptoms of the well remembered, unmotivated infanticide included flat affect, olfactory and command hallucinations, and delusions of grandeur (his mother leaving him millions and power).