Pontius A A
Harvard Medical School, Department of Psychiatry (APS), Boston, MA, USA.
Percept Mot Skills. 1999 Jun;88(3 Pt 1):970-82. doi: 10.2466/pms.1999.88.3.970.
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.
23名未经挑选的青少年纵火者（平均年龄12.0岁）包括7名患有精神分裂症、3名患有器质性精神障碍、6名患有创伤后应激障碍、2名患有重度智力障碍以及2名患有品行障碍的青少年。三名之前并无破坏行为的男孩（平均年龄11.0岁），他们都是独来独往的人，不符合此类传统诊断。他们短暂（约20分钟）的症状包括情感平淡、自主神经兴奋以及妄想或幻觉。似乎他们毫无动机、未经计划的行为每次都先有一次偶然遇到个性化刺激的经历，这种刺激唤起了这三个男孩反复思考的、与火、烟或火柴相关的仅为中度压力的间歇性经历的记忆。这样一系列事件是癫痫发作点燃现象的特征。一名男孩异常的脑电图与颞叶区域的癫痫发作相符，颞叶区域包括杏仁核，即边缘系统中特别容易引发癫痫发作点燃现象的部分。这三个男孩一致的症状与17名有怪异杀人行为的男性所报告的症状非常相似，这些行为涉及一种被称为“边缘性精神病触发反应”的点燃性部分癫痫发作。在灵长类动物中，类似的伴有精神病样症状的部分非惊厥性“行为性癫痫发作”也可通过经验性点燃诱发。
