A NEW CASE OF FLUCTUATING HALF-BRAIN DOMINANCE IN A YOUNG ADULT AGED TWENTY-TWO (Updated with drug therapy results).

Renato COCCHI, neurologist and medical psychologist

 

Summary.

The case of a youth of twenty-two years with problems of fluctuating half-brain dominance is reported. Perceived from the patient, who described them as abnormal facts, they were the intrusive thought, the opposite contents, negative emotions and the onset of bad thought against beloved persons. Even anxiety, depression and fear to become a crazy person were also present. The stress symptoms were fewer and altogether poorly meaningful.

Key words: Reversebrain, half-brain dominance, intrusive thinking, opposite contents, negative emotions, anxiety, depression, stress, psychosis, brain rhythms, EEG

Italian translation

Clinical cases

Reversebrain

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I had the chance to observe a new case of fluctuating half-brain dominance. This fact was occurring in a youth of twenty-two years, perfectly aware that what happened did not represent his normalcy.

Of this case, for certainly unusual and with revealing aspects, I want to give here the report.

 

The case history.

Male of twenty-two years, with eight years of school attendance, a carpenter, engag‚. He is not taking any drug therapy. In his family there is a depressive predisposition from the fatherly part.

He had problems at his birth, he was always a little reserved, he doesn't do any sport.

Recently he had some heavy alcoholic abuse, but from the last episode he did not drink ever again.

28.04. 2004: In some moments of the day he is anxious, much of fear, intrusive thinking (not always so). The moments of crisis are in the morning.

To the test: "Say the opposite of the colour Red," he answers White. He denies being a Contrary Mary. He has bad thoughts against beloved persons. During the fear moments, he inclines to cry as reaction to something that he feels as extraneous. When he attended the school, he went better in mathematics. He needs top count things, without being necessary. Sometimes he suffers from a pulsating type bitemporal headache. Often he is much emotionally involved by auditory contents, and considers them for long. He has obsessive mental repetition of songs, which he used to hum to do stop them. When he is badly, apply more to sexual activities. She would verge to howl, but he refrains himself. Several times he has thought to throw down from the scaffolding of the yard. He succeeds to feel better if he drives the car or he plays cards (to the trump).

He is well falling asleep, but he has wake ups again after 4-5 hours of sleep. He doesn't talk in his sleep, currently not has nighttime bruxism, as he did in past. He has some dental shut during the day. No bad dreams occurred, nor nighttime muscle cramps, but he has cramps by day in the swimming pool.

He slobbers during his sleep. His morning wake up is without any tiredness, but he has no willingness. Not early-morning feelings of nausea or retching reported. His breakfast is at once. Any greediness for sweet things, normal greediness for the meat broth, he does not eat milk and dairy products.

Now he bears badly noise and confusion, but any dyslalias, any disbandment feelings, any faint feelings were reported. He is better towards evening. He is using to bit her nails, has dry hairs, has hand and axillary oversweating. Normally, he suffers more the cool, not has any tachycardia, but mediastinal oppression and lump in the throat, any colic and diarrheas, but regular bowel function. He does not need to urinate frequently. He has sudden asthenias, and days with the pallor and eye sockets.

He had personally written some notes, which I read at the end of the consultation. I transcribed them here corrected as for potentially dialect passages.

"My head does not stop to think, but my thinking goes always to end in the fears, for example, to become crazy or to do some stupidity. It is as if there was somebody who imposes me to doing that. After all I say me of not doing it because I do not want to do it. Often my thoughts, which are the 70% of the thoughts of my day, become superimposed since I have very much of them, and drive me to an absurd unhappiness that gets off me in my stomach. So I am doing a complex that I will not recover anymore. When I think about something as beautiful I cannot succeed to be happy. On the contrary, absurd unhappiness gets round on me while, when I was well off, I was always happiest with that same thought.

Then, when I am badly, and I think, I move even the mouth without speaking, and I create discourses that I probably could do with the mouth, but giving me the answer that I will never recover.

Other times I cannot succeed to control my feelings, and this frightens me then jumps out of my fear that I should have a long agony and I should lose everything.

The words said by other persons upset me much and I would like not to listen, and I think even about they would say on me. An other thing that disturbs me much, when I am badly, is all that things I have seen when my sister was badly and she did. My fear is that even I could do them.

When I wake up in the mornings, I am much agitated and anxious, even because I wake up always before my mama calls me, for which I stay [I feel me] much scary and I say me: What I have? Am I sick?

Then, to do I feel well, when I start to think I have to stop at once, because otherwise I think always more badly and even if I stop to think, it seems I am leaving something of incomplete. But I pluck up courage to don't end my thought.

I went to Genoa, and I was watching directly the persons and it seemed me to know some ones, then to the end I realized that I made a mistake. I am afraid that I have some symptom like those of a person who is going to become crazy and I to lose any trust in myself.

I was among the people, and some times it came in my mind to do some stupid behaviour as, for an example, to scream or tp throws me into the water. I don't understand if these things passed me in my head to do for others seeing I am badly, or because I am demented. I have the doubt that those thoughts I had even first when I was well off and now I am afraid that I will have them for ever.

When I am taking an action, it is as my brain swerves and obliges me to do it in a wrong, foolish way. Nevertheless then I do it right because it needs to be done so and this frightens me. I am full of a thousand fears."

 Test therapy (daily doses, by the oral via): L-glutamine 125mg; Pyridoxine 75mg; Chlomipramine 10mg; Carbamazepine 200mg; Bromazepam 0.6mg.

Second ten days of June 2004: The first checkup.

He has a more serene and relaxed face. He says to feel much better. At night he sleeps well. His work seems not so heavy as first, and he is more constant in it. The "bad thoughts" much decreased, but he has some depressive moments and does not cease to eat his fingernails. No more need occurred to count objects for no reason. The pulsating headache stopped. The acoustic threshold for noise stress is less low.

His brain missed unintentionally repeating songs. He did not attend the swimming pool, and so he doesn't know if he had muscular cramps. The dental shut disappeared, so as the nighttime drooling. Now, he inclines to eat more chocolate. The intake of milk and dairy did not vary. Now, he bears better the confusion, a little less the noise. Around evening, he feels better, but he does not badly even during the day. His oversweating did not change. Mediastinal oppression and the lump in the throat missed. Not more sudden asthenias occurred. He doesn't have days of pallor with the eye sockets anymore.

He doesn't need to howl. Still, sometimes he starts crying. Bo more feelings than extraneousness came out. Ideas of dying left him. Now, he doesn't have more the need of feeling better by driving a car or by playing cards. The worse daily time is always the morning, but lesser than in past. His character did not change. His compensatory sexual activity reduced. He regained his weigh-form, while he was thinner.

Therapeutic variation (daily doses, by the oral via): Glutamine 250mg; Chlomipramine 20mg.

Third ten days of September 2004: The second checkup.

He did not dear the increase of the glutamine and of the chlomipramine, and so he took the preceding doses of them. Meanwhile, he still improved. Depressive thoughts still occur. He missed the "bad thoughts" against beloved persons. His work proceeds better. If "bad thoughts" come, they do not do so during the work, but during the pause. Even the relationships with the parents improved and he is recuperating the character he had before doing badly. With his girlfriend, it is all OK, even with her parents.

His mother had high blood tension in pregnancy and probably the fetus suffered. His delivery was with caesarian section for premature breakup of the amniotic sac. In his first year of life, he was eating and sleeping well, but he was always pale. He was catching easily upper respiratory tract infections. Normal intestinal function ran, but with rather liquid faeces. He had a hypertonic episode, without any apparent reason, about in his the third month of life.

Therapeutic variation (daily doses, by oral via): Carbamazepine 300mg; Bromazepam 1mg.

 

Third ten days of January 2005: The third checkup.

He is doing well off. In the morning he gets more thoughts but they go off during the forenoon. The intrusive thought starts just when he wakes. There was not any change as for his hairs, but his beard is growing much faster. He is always a little sensitive. Now he is doing well off even on Saturday and on Sunday, when he does not work.

Therapeutic variation (daily doses, by the oral via): Hanging bromazepam, I prescribed lorazepam 1mg.

Second ten days of July 2005: The fourth checkup. In last February he acted an EEG check, which reported a whole deceleration of the alpha rhythm to 8 c/s and theta presence to 7 c/s, more evident in the right half-brain. Since six months he had only a bad dream and he is more serene. His sexual activity regularized, the appetite is good. Now, in morning too, he has fewer intrusive thoughts. He says that his hairs became more bristly [thicker?]

No therapeutic variation.

Third ten days of July 2006: The fifth checkup.

In the EEG is evident deceleration of the brain rhythms in both-side temporal-occipital area. He is suffering from the summer heat, since in this time, of fact, the weather is warm. Specifically asked, he says he has always taken the prescribed drugs [???]. When he forgot taking the evening therapy, at night he had dreams, even bad ones, of which he remembered to the morning.

Now he is feeling a little anxious, with restarting of the intrusive thought. He inclines to react more in irritating way. Suicide ideas are fully missing. He has kept some body fat. When he is on holidays, after a short time he feels worse. His bowel function runs well, while in past he had spastic constipation with halitosis.

He observed that when he is speaking, he has greater awareness of what he is saying [Gets he better verbal-brain feedback?]. In this time he eats much his fingernails. When he came back from the sea, he had some depressive moments. Only now he admitted that in past, when he felt much badly, he thought and he feared of becoming a homosexual.

Therapeutic adjustment (daily doses, by the oral via); Lorezepam 1.5mg; Carbamazepine 400mg; Chlomipramine 20mg; Glutamine 125mg; Pyridoxine 75mg.

 

Discussion.

Naturally, as I have written previously, the fluctuating half-brain dominance does never implicate the whole not-dominant half-brain, but some of its functions, mainly that emotional ones.

The case described here has notable interest not only for its characteristics as I found during the first visit, but because the youth had prepared some notes, which showed a notable introspection.

I now can list what already the same patient individuated:

Intrusive thinking:

- "My head does not stop to think, ..."

- "I have the doubt that those thoughts I had even first when I was well off ..."

- "Often my thoughts, which are the 70% of the thoughts of my day, become superimposed since I have very much of them. ..."

Opposite contents:

- "... but my thinking goes always to end in the fears, for example, to become crazy or to do some stupidity."

- " It is as if there was somebody who imposes me to doing that. After all I say me of not doing it because I do not want to do it."

- "... absurd unhappiness gets round on me while, when I was well off, I was always happiest with that same thought."

- "... when I start to think I have to stop at once, because otherwise I think always more badly and even if I stop to think, it seems I am leaving something of incomplete."

- " I was among the people, and some times it came in my mind to do some stupid behaviour as, for an example, to scream or tp throws me into the water."

- " When I am taking an action, it is as my brain swerves and obliges me to do it in a wrong, foolish way."

Negative feelings:

- ... and drive me to an absurd unhappiness that gets off me in my stomach. So I am doing a complex that I will not recover anymore.

- When I think about something as beautiful I cannot succeed to be happy. On the contrary, absurd unhappiness ...

- ... and this frightens me then jumps out of my fear that I should have a long agony and I should lose everything.

- The words said by other persons upset me much and I would like not to listen, and I think even about they would say on me.

- I am afraid that I have some symptom like those of a person who is going to become crazy and I to lose any trust in myself.

In the preceding cases described by me (Cocchi, 1996; 1998; 2001; 2002a; 2002b; 2002c; 2002d; 2003), if it were any doubt that I forced a little the interpretation of the symptoms the patients mourned, this time we may be more sure. It is the same patient that described exactly his state of discomfort and the fear to become a crazy person, over that the opposite contents of his thoughts.

Even the depressive answer to the test "Say the opposite of the colour Red" what had to be "Black," it was transformed in the opposite as White.

Only following a direct question he admitted having bad thoughts against otherwise beloved persons. In his writing he did not successfully to render this situation explicit, a source of much anxiety ("fear") even if it may be glimpsed.

The evident depression, with even suicide ideas, could have a triple origin, being the common final pathway: i. Familiarity; ii. From the complications of his birth; iii. As secondary reaction to his current condition, continuously compared with that of his sister who suffered from a psychotic illness.

In its "career" of mentally disturbed he learned to put into action mechanisms of consumption or of compensation that work modestly. This is to bite his fingernails, and the need to howl (that he never acted), to sing ti himself to stop the musical tune that his head is repeating, the need to count, the increasing of the sexual activity, to drive the car or to play cards.

The patient is perfectly aware of the compensation function, vulgarly said "of unloading," of some of these symptoms.

An other differing element is that the stress symptoms, at least how I know them, are modest and without particular features. They are: awakenings after 4-5 hours of sleeping; daily dental shut; to slobber during the sleep; to bear badly noise and confusion; the mediastinal oppression and the lump in the throat; the sudden asthenias.

On the other hand, the depressive symptoms, about which I previously wrote, have better characteristics, but even they, over the weeping for the fear to become a crazy person, do not much specificity.

 

Conclusions.

The description of this new case brings meaningful elements of support to the thesis of the possibility of a fluctuating half-brain dominance for emotional contents, but not only for them. There is to ask ourselves which relationships are among symptoms of this type and some psychotic evolution, which, at this stage, would be able even seen as a defence mechanism having the aim of saving the savable.

By limiting the mental life by putting the mechanisms of criticizing and of judgment out, and then to rest to a level of less evolved mental operation, could be just something of this type.

 The EEG confirmed slow brain rhythms, in the temporal-occipital areas, which I observed as prevailing in the right half-brain. The antiepileptic, antistress and antidepressant therapy did very positive results, but, by now, because of little regressions, I could not still discover its really optimal dosing.

 

References.

Cocchi R.: Intrusive opposite emotional thinking in a chronic "schizo-affective" woman. A stabilized inverse half.-brain dominance of a specific function? It. J. Intellect. Impair. 1996, 9: 153-168. <www.reversebrain.net/Case1.htm>.

Cocchi R.: Opposite half-brain dominance of specific functions? Another case in a Down child under drug therapy. It. J. Intellect. Impair. 1998. 11: 151-156. <www.reversebrain.net/case2.htm>.

Cocchi R.: Temporary reverse dominance of some brain function in a man aged forty-six. February 2001, <www.reversebrain.net/Case3.htm>.

Cocchi R.: A girl aged ten with Smith-Magenis syndrome and possible reverse brain dominance of some brain functions. April 2002a, <www.reversebrain.net/Case4.htm>.

Cocchi R.: Three young persons with problems of reverse half-brain dominance. January 2002b, <www.reversebrain.net/Case5.htm>.

Cocchi R.: A child of 8 years with probable problems of inverse brain dominance. April 2002c, <www.reversebrain.net/Case6.htm>.

Cocchi R.: The strange evolution after drug therapy in a subject with opposite conducts and attention deficit disorder with hyperkinesis. November 2002d, <www.reversebrain.net/Case7.htm>.

Cocchi R.: Troubles of the half-brain dominance, in three dropout university students. Ottobre 2003, <www.reversebrain.net/Cases8.htm>.

 

Posted on internet on 13 July 2004: Copyright by Renato Cocchi, 2004.

Author's addrees: dr Renato COCCHI, via Rabbeno, 3

42100 Reggio Emilia (Italy).

renatococchi@libero.it  

 

Testo in italiano

Clinical cases

Reversebrain

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