Originally posted by S = k log w
How can I tell the difference between an Epileptic, a Bi-Polar, and a Schizophenic?
Loaded question. Bipolar disorders and schizophrenia are in a constant state of flux regarding their definitions. I have heard a rumor, for instance, that the next edition of the Diagnostic and Statistical Manual of Mental Disorders is going to include a new category of bipolar disorder. (There are currently 4 catagories of bipolar: Bipolar 1, Bipolar 2, Cyclothymic Disorder, and Bipolar Disorder Not Otherwise Specified.)
Psychiatry applies labels according to symptoms. They have never been able to isolate a specific organic cause for "schizophrenia" for example. Instead, research has come up with a bag of miscellaneous possible causes: enlarged ventricles, allergies, viral damage to the brain, and so on. So, there is actually no such animal as "schizophrenia" in the way there is Parkinson's disease or Multiple Sclerosis or Seizure Disorders. The same is true of bipolar.
The difference between seizures and strange behaviour due to other causes can only be definitively proven by detection of seizure activity with an EEG.
The trouble is that the EEG is limited to picking up signals occurring near the surface of the brain. Using the technique of depth implanted electrodes to specifically locate the seizure focus in people being prepared for epilepsy surgery, it was discovered that often the bulk of seizure activity is occurring at depths that will never be picked up with a surface EEG. A study I read found that in the case of simple partial seizures, only 21% showed up on the surface EEG! This presents the physician with the problem that, while an EEG positive for seizure activity rules a seizure in, an EEG negative for seizure activity cannot rule a seizure out.
This being the case, the best course of action is to be sure to include thorough questioning of the patient concerning experiences that are known seizure symptoms. For example, if a person comes with a primary complaint of hearing voices and fear there is a grand conspiracy against them, in depth questioning might also reveal a frequent feeling that they have left their body and are floating above it (simple partial seizure) as well as a peculiar, rising fluttery feeling in the stomach area (simple partial seizure). Then, instead of injecting them with Haldol or Prolyxin, which will just lower the seizure threshold and make things considerably worse, an appropriate medication would be tried.