thumb|A letter written by artist [[Emma Hauck while institutionalized in a mental hospital; many of her letters consist of only the written words "come sweetheart" or "come" repeated over and over in flowing script]]

Hypergraphia is a behavioral condition characterized by the intense desire to write or draw. Forms of hypergraphia can vary in writing style and content. It is a symptom associated with temporal lobe changes in epilepsy and in Geschwind syndrome. Structures that may have an effect on hypergraphia when damaged due to temporal lobe epilepsy are the hippocampus and Wernicke's area. Aside from temporal lobe epilepsy, chemical causes may be responsible for inducing hypergraphia.

Characteristics

Writing style

American neurologists Stephen Waxman and Norman Geschwind were the first to describe hypergraphia, in the 1970s.

A patient from a separate study experienced continuous "rhyming in his head" for five years after a seizure and said that he "felt the need to write them down." The patient did not talk in rhyme, nor did he read poetry. Language capacity and mental status were normal for this patient, except for recorded right-temporal spikes on electroencephalograms. This patient had right-hemisphere epilepsy. Functional MRI scans of other studies suggest that rhyming behavior is produced in the left hemisphere, but Mendez proposed that postictal hypoactivity of the right hemisphere may induce a release of writing and rhyming abilities in the left hemisphere. and Dyane Harwood) use their hypergraphia to help them write extensive papers and books, most patients do not write things of substance. Flaherty describes hypergraphia as a result of decreased temporal lobe function which disinhibits frontal lobe idea and language generation, "sometimes at the expense of quality." Patients hospitalized with temporal lobe epilepsy and other disorders causing hypergraphia have written memos and lists (like their favorite songs) and recorded their dreams in extreme length and detail. In one case study, a patient even wrote backward, so that the writing could only be interpreted with the aid of a mirror. The composer Robert Schumann, during periods of high musical output, also wrote many long letters to his wife Clara; similarly, Vincent van Gogh had much more written correspondence during bouts of intense painting.

Causes

Some studies have suggested that hypergraphia is related to bipolar disorder, hypomania, and schizophrenia. and chemical causes.

Temporal lobe epilepsy

thumb|Annotated diagram of the brain's lobes - the temporal lobe is labelled and highlighted green.

Hypergraphia was first studied as a symptom of temporal lobe epilepsy, a condition of reoccurring seizures caused by excessive neuronal activity, but it is not a common symptom among patients. Less than 10 percent of patients with temporal lobe epilepsy exhibit characteristics of hypergraphia. Temporal lobe epilepsy patients may exhibit irritability, discomfort, or an increasing feeling of dread if their writing activity is disrupted. To elicit such responses when interrupting their writing suggests that hypergraphia is a compulsive condition, resulting in an obsessive motivation to write. A temporal lobe epilepsy may influence frontotemporal connections in such a way that the drive to write is increased in the frontal lobe, beginning with the prefrontal and premotor cortex planning out what to write, and then leading to the motor cortex (located next to the central fissure) executing the physical movement of writing. In fact, temporal lobe epilepsy is more likely to produce hypergraphia if it also produces manic symptoms. While depression has been linked to increased writing, it appears that most writers with depression write little while depressed, and high output periods correspond to rebound mood elevation after the end of a depression, or in mixed mood states. This research implies that there is a direct correlation between the levels of dopamine between neuronal synapses and the level of creativity exhibited by the patient. Dopamine agonists increase the levels of dopamine between synapses which results in higher levels of creativity, and the opposite is true for dopamine antagonists.

In one case study, a patient taking donepezil reported an elevation in mood and energy levels which led to hypergraphia and other excessive forms of speech (such as singing). Six other cases of patients taking donepezil and experiencing mania have been previously reported. These patients also had cases of dementia, cognitive impairment from a cerebral aneurysm, bipolar I disorder, and/or depression. Researchers are unsure why donepezil can induce mania and hypergraphia. It could potentially result from an increase in acetylcholine levels, which would have an effect on the other neurotransmitters in the brain. An area of the frontal lobe that is especially active is Exner's area, located in the premotor cortex. Lesions to Wernicke's area (in the left temporal lobe) can increase speech output, which can sometimes manifest itself in writing. While epilepsy-induced hypergraphia is usually lateralized to the left cerebral hemisphere in the language areas, hypergraphia associated with lesions and other brain damage usually occurs in the right cerebral hemisphere. Lesions to the right side of the brain usually cause hypergraphia because they can disinhibit language function on the left side of the brain.

Society and culture

<!-- Please review WP:MEDMOS before adding speculation here-->

Hypergraphia was one of the central issues in the 1999 trial of Alvin Ridley for the imprisonment and murder of his wife Virginia Ridley. The mysterious woman, who had died in bed of apparent suffocation, had remained secluded in her home for 27 years in the small town of Ringgold, Georgia, United States. Her 10,000-page journal, which provided abundant evidence that she suffered from epilepsy and had remained housebound of her own will, was instrumental in the acquittal of her husband. Other artistic figures reported to have been affected by hypergraphia include Vincent van Gogh, Fyodor Dostoevsky, and Robert Burns. Alice in Wonderland author Lewis Carroll is also said to have had the condition, having written more than 98,000 letters in various formats throughout his life. Some were written backward, in rebus, and in patterns, as with "The Mouse's Tale" in Alice.

Eleanor Alice Burford, whose pen-names included Jean Plaidy, Victoria Holt, Philippa Carr, Eleanor Burford, Elbur Ford, Kathleen Kellow, Anna Percival, and Ellalice Tate, described herself as a compulsive writer.

Naomi Mitchison, often called a doyenne of Scottish literature, writing over 90 books of historical and science fiction, travel writing and autobiography, has been described as a compulsive writer.

See also

  • Automatic writing
  • Free writing
  • Graphomania

References

Further reading

  • Pickover, C. A. (1999). Strange brains and genius: The secret lives of eccentric scientists and madmen. New York: William Morrow.
  • Schachter, S. C., Holmes, G. L., & Kasteleijn-Nolst Trenité, D. (2008). Behavioral aspects of epilepsy: Principles and practice. New York: Demos.