Misplaced Pages

#945054

50-412: The events in the novel take place between March 9 and March 13, 1971. Harold Franklin "Harry" Benson, a computer scientist in his mid-thirties, is described as suffering from " psychomotor epilepsy " following a car crash two years earlier. He often has seizures followed by blackouts , and then wakes up hours later with no knowledge of what he has done. During these seizures, he severely beats two people;

100-694: A cardiac pacemaker , defibrillator or cochlear implant may receive a CT scan. CT scan may better demonstrate calcium containing brain abnormalities causing epilepsy such as in tuberous sclerosis and Sturge–Weber syndrome . Anticonvulsant oral medications control seizures in about two-thirds of persons with epilepsy, and control commonly occurs with one or two medications. Those with uncontrolled seizures despite treatment with multiple anticonvulsant medications have pharmacoresistant epilepsy, and they may require epilepsy surgery to achieve seizure control. Penfield and Flanigan first described anterior temporal lobectomy , partial surgical removal of

150-466: A British boy had a neurostimulator fitted inside his skull, sending electrical signals deep into his brain to control seizures. Temporal lobe epilepsy In the field of neurology, temporal lobe epilepsy is an enduring brain disorder that causes unprovoked seizures from the temporal lobe . Temporal lobe epilepsy is the most common type of focal onset epilepsy among adults. Seizure symptoms and behavior distinguish seizures arising from

200-557: A Warner Bros international marketing executive, attempted to override Warner Bros' decision not to release the film in Britain, he sought Kubrick’s help. After explaining the situation, and how the film required a different marketing campaign, Kubrick interrupted with, “I’ve already seen it and it’s terrific.” The director Terrence Malick wrote to Hodges expressing how much he loved watching The Terminal Man , saying "I have just come from seeing The Terminal Man and want you to know what

250-416: A brain region of decreased glucose metabolism at a time between seizures; this hypometabolic region may correspond to the seizure focus, and PET scan is more sensitive for temporal lobe seizure focus localization compared to epilepsy arising from other brain lobes. Single-photon emission computed tomography (SPECT) may show a region of decreased blood flow occurring 40-60 seconds after injection during

300-405: A computer senses an oncoming seizure. Ellis argues he is not convinced that not operating will do Benson any favors; Benson's condition threatens Benson's life and those of others, has already undermined Benson's legal status three times, and is worsening. Despite the concerns voiced, the team decides to go ahead with the operation. Forty electrodes are implanted into Benson's brain, controlled by

350-422: A focal to bilateral tonic-clonic seizure. Impaired language function ( dysphasia ) during or soon following a seizure is more likely to occur when seizures arise from the language dominant side of the brain. The major cognitive impairment in mesial temporal lobe epilepsy is a progressive memory impairment. This involves declarative memory impairment, including episodic memory and semantic memory , and

400-510: A good one." Nora Sayre gave the film a negative review in The New York Times , describing it as dull and slow: "George Segal's resilience, humor, and versatility have redeemed quite a few bad scripts. But this role gives him little chance to act, beyond making like a Zombie and rolling his eyeballs back..." Stanley Kubrick was a Hodges admirer – “Any actor who sees Get Carter will want to work with him.” When Mike Kaplan,

450-491: A granule cell layer that is widened, poorly demarcated, or accompanied by granule cells outside the layer (ectopic granule cells). In the normal brain, dentate granule cells block seizure spread from entorhinal cortex to the hippocampus. A hypothesis is that granule cell dispersion may disrupt the normal mossy fiber pathway connecting granule cells and CA3 pyramidal cells leading to mossy fiber sprouting and new excitatory networks capable of generating seizures. However,

500-400: A magnificent, overwhelming picture it is. You achieve moods that I’ve never experienced in the movies before, though it’s only in hope of finding them that I keep going. Your images make me understand what an image is , not a pretty picture but something that should pierce one through like an arrow and speak in a language all its own." On its release at the 2003 Edinburgh Film Festival, there

550-407: A mechanic who has been beaten by Benson, Morris is attacked and injured as well. Back at the hospital, Ross receives a phone call from Benson, which is traced to somewhere inside the building. The hospital's computers begin to malfunction, as if somebody were disturbing the mainframe. Ross and Anders go down into the basement, where Anders exchanges fire with and injures Benson before becoming lost in

SECTION 10

#1732790318946

600-683: A more severe epilepsy. Mechanisms related to neuronal loss incompletely account for temporal lobe epilepsy as temporal lobe epilepsy may occur with only minimal neuronal cell loss. This KCC2 mutation prevents subicular neurons from potassium and chloride ion extrusion, leading to intracellular chloride accumulation, and positive γ-Aminobutyric acid (GABA) mediated currents. Accumulated chloride efflux through GABA receptors leads to neuronal depolarization , increased neuronal excitability and ultimately seizures. Persons with this mutation have mesial temporal lobe epilepsy with hippocampal sclerosis. Dentate gyrus granule cell dispersion refers to

650-479: A peephole looking into the camera and telling the audience that they are next for the medical procedure. Crichton was originally hired to adapt the novel himself in 1971, but Warner Bros. felt he had departed from the source material too much and had another writer adapt it. "I don't think they [Warner Bros] gave it a chance," said Crichton later. The film was shot in Los Angeles and Burbank Studios , with

700-541: A seizure. The common medial temporal lobe seizure auras include a rising epigastric feeling, abdominal discomfort, taste (gustatory), smell (olfactory), tingling (somatosensory), fear, déjà vu , jamais vu , flushing , or rapid heart rate ( tachycardia ). A person may then stare blankly, appear motionless ( behavioral arrest ) and lose awareness. Repeated stereotyped motor behaviors ( automatisms ) may occur such as repeated swallowing, lip smacking, picking, fumbling, patting or vocalizations. Dystonic posture

750-420: A small computer that is powered by a plutonium power pack in his shoulder. Benson must wear a dog tag with instructions to call University Hospital if he is injured, as his power pack may emit radiation. During the procedure, the implant deviates slightly from its planned path, but this is corrected. While he is recovering, a woman identifying herself as Angela Black gives Morris a black wig for Benson following

800-422: A study has shown that a similar pattern of granule cell dispersion may occur in persons without epilepsy. Focal cortical dysplasia is a brain malformation that may cause temporal lobe epilepsy. This malformation may cause abnormal cortical layers ( dyslamination ), occur with abnormal neurons ( dysmorphic neurons, balloon cells ) and may occur with a brain tumor or vascular malformation. An abnormality of

850-512: Is major depressive disorder . Other disorders include post-traumatic stress disorder , general anxiety disorder , psychosis , obsessive-compulsive disorder , schizophrenia , bipolar disorder , substance use disorder and a ~9% prevalence of suicide . Geschwind syndrome is a syndrome of altered sexuality (most often hyposexuality), religiosity , and compulsive or extensive writing and drawing occurring in persons with temporal lobe epilepsy. However, subsequent studies did not support

900-811: Is a 1974 American horror science fiction film directed by Mike Hodges , based on the 1972 novel of the same name by Michael Crichton . Starring George Segal and Joan Hackett , the film centers on the danger of mind control and the power of computers . Harry Benson, an intelligent ( IQ 144) computer scientist in his 30s, suffers from epilepsy . He often has seizures that induce blackouts, after which he awakens to unfamiliar surroundings with indications of violent behavior on his part. He also suffers from delusions that computers will rise up against humans. Benson suffers from Acute Disinhibitory Lesion syndrome and consents to an experimental psychosurgical procedure known as "Stage Three". Stage Three requires surgeons to implant electrodes in his brain, which will detect

950-450: Is advised for those with evidence of focal epilepsy such as temporal lobe epilepsy. Abnormalities identified by MRI scan include hippocampal sclerosis, focal cortical dysplasia, other cortical developmental brain malformations, developmental and low-grade tumors, cavernous hemangioma , hypoxic-ischemic brain injury , traumatic brain injury and encephalitis. F-fluorodeoxyglucose ( F-FDG) brain positron emission tomography (PET) may show

1000-415: Is an unnatural stiffening of one arm occurring during a seizure. A dystonic posture on one side of the body commonly indicates seizure onset from the opposite side of the brain e.g. right arm dystonic posture arising from a left temporal lobe seizure. Impaired language function ( dysphasia ) during or soon following a seizure is more likely to occur when seizures arise from the language dominant side of

1050-416: Is apparent that his brain has become addicted to the electrical impulses. The seizures are triggering at increasingly shorter intervals. When they become continuous, Benson will be in a permanent blackout, with the violent behavior that goes with it. Just before Ross realizes what is happening, Benson escapes from the hospital. He becomes unpredictably violent, but his intact intelligence allows him to evade

SECTION 20

#1732790318946

1100-469: Is found at the murder scene of Angela Black, Ross is questioned by police. Benson confronts Ross in her house and attacks her upon having a seizure. Just before losing consciousness, Ross manages to turn on her microwave oven, the radiation of which affects the power pack in Benson's shoulder and forces him to flee. Morris uses a book of matches found on Angela's body to track Benson to an airport hotel. Finding

1150-456: Is worse when medications fail to control seizures. Mesial temporal lobe epilepsy arising from the language dominant hemisphere impairs verbal memory , and mesial temporal lobe epilepsy arising from the language non-dominant hemisphere impairs nonverbal memory . Psychiatric disorders are more common among those with epilepsy, and the highest prevalence occurs among those with temporal lobe epilepsy. The most common psychiatric comorbidity

1200-523: The medial temporal lobe from seizures arising from the lateral (neocortical) temporal lobe . Memory and psychiatric comorbidities may occur. Diagnosis relies on electroencephalographic (EEG) and neuroimaging studies. Anticonvulsant medications , epilepsy surgery and dietary treatments may improve seizure control. Under the International League Against Epilepsy (ILAE) 2017 classification of

1250-660: The Forest Lawn Cemetery and the Ennis House serving as locations in the film. When preparing the film, Hodges wanted to shoot in black and white but the studio would not let him. The film was influenced by the work of Edward Hopper . “The American painter Edward Hopper was relatively unknown here in those days. I certainly had never heard of him. Something made me pick up a book of his paintings in Pickwick's bookshop on Hollywood Boulevard. I opened it and there

1300-579: The MTOR pathway leads to hyperexcitable glutamate mediated neurons leading to seizures. The temporal lobe epileptiform discharge is a pattern seen on the electroencephalgram (EEG) test; temporal lobe epileptiform discharges occur between seizures and confirm the diagnosis of temporal lobe epilepsy. Long-term video-EEG monitoring may record the behavior and EEG during a seizure. Magnetoencephalography may diagnose temporal lobe epilepsy by recording epileptiform discharges or seizure patterns arising from

1350-515: The abnormal brain tissue that causes seizures. Neurostimulation may also improve seizure control. The vagus nerve stimulator (VNS) is surgically implanted in the chest, and delivers programmed electrical stimulation to the vagus nerve in the neck. The responsive neurostimulation device is implanted in the skull, monitors electrical brain activity for seizures, and responds to seizures with programmed electrical stimulation to one or two brain areas. Programmed deep brain stimulation of

1400-486: The anterior thalamic nucleus may treat seizures arising from more than 2 brain areas. The ketogenic diet and modified Atkins diet are additional temporal lobe epilepsy treatment options. Among those who develop childhood temporal lobe epilepsy, epilepsy remits in about one-third of children. Remission was more likely among those without hippocampal sclerosis , brain tumor, or focal cortical dysplasia on MRI scan. The Terminal Man (film) The Terminal Man

1450-602: The association of these behavioral traits with temporal lobe epilepsy. There are reports of religious behaviors occurring in persons with temporal lobe epilepsy. Hippocampal sclerosis , brain tumor , traumatic brain injury , cerebral vascular malformation , neuronal migration disorders , infections such as encephalitis and meningitis , autoimmune disease ( limbic encephalitis ) and genetic disorders may cause temporal lobe epilepsy. Many persons with uncontrolled temporal lobe epilepsy had childhood febrile seizures . A brief febrile seizure only slightly increases

1500-508: The brain. The common auras from seizures arising from primary auditory cortex include vertigo , humming sound, ringing sound, buzzing sound, hearing a song, hearing voices or altered hearing sensation. Lateral temporal lobe seizures arising from the temporal- parietal lobe junction may cause complex visual hallucinations. In comparison to medial temporal lobe seizures, lateral temporal lobe seizures are briefer duration seizures, occur with earlier loss of awareness, and are more likely become

1550-528: The cell loss pattern of temporal lobe epilepsy in humans. Repetitive seizures irreversibly damage interneurons leading to persistent loss of recurrent inhibition . Damage of GABAergic interneurons lead to loss of inhibition, uncontrolled neuronal firing , leading to seizures. The secondary epileptogenesis hypothesis is that repetitive seizures lead to interneuron loss, loss of glutamatergic principal neurons , axonal sprouting, and formation of new recurrent glutamatergic excitatory circuits leading to

The Terminal Man - Misplaced Pages Continue

1600-507: The day before his admission, he was arrested after attacking a third. He is a prime candidate for an operation to implant an electronic " brain pacemaker " in the amygdala region of his brain in order to control the seizures, which will be performed in the Neuro-Psychiatric Service (NPS) of University Hospital. Two NPS surgeons, John Ellis and Robert Morris, are to perform the unprecedented surgery. The ramifications of

1650-419: The entire seizure; awareness may be retained even if impaired responsiveness occurs during the seizure. A focal impaired awareness temporal lobe seizure occurs if a person becomes unaware during any part of the seizure. During a temporal lobe seizure, a person may experience a seizure aura ; an aura is an autonomic, cognitive, emotional or sensory experience that commonly occurs during the beginning part of

1700-404: The epilepsies , focal onset epilepsy occurs from seizures arising from a biological neural network within a single cerebral hemisphere . Temporal lobe epilepsy occurs from seizures arising within the temporal lobe. Temporal lobe epilepsy is the most common focal onset epilepsy, and 80% of temporal lobe epilepsy is mesial (medial) temporal lobe epilepsy , temporal lobe epilepsy arising from

1750-462: The first 10 minutes, which was excruciating. American audiences found the film too uncompromising, too tough to take. The reviews were dire. I think people had a problem accepting George Segal in the lead role. At that time, he was known as a light comedian, but I wanted him for the film. I liked the fact that it was unusual casting. He is terribly good in it and, now that his career is not too top heavy with comedy, you can see him purely as an actor – and

1800-466: The head of the NPS, interviews Benson and realizes Manon and Ross were right about his psychosis, ordering nurses to administer thorazine to Benson. After resting for a day, Benson goes through "interfacing". The electrodes are activated one by one to test which ones would stop a seizure. Each electrode produces different results; one stimulates a sexual pleasure. Gerhard, one of the technicians administering

1850-438: The inner ( medial ) part of the temporal lobe that may involve the hippocampus , parahippocampal gyrus or amygdala . The less common lateral temporal lobe or neocortical temporal lobe seizures arise from the outer ( lateral ) temporal lobe. The ILAE 2017 classification distinguishes focal aware from focal impaired seizures. A focal aware temporal lobe seizure occurs if a person remains aware of what occurs during

1900-437: The magnetic fields of neural electrical currents. Neuroimaging tests may identify the cause for seizures and the seizure focus , the brain location where seizures begin. In newly diagnosed epilepsy, magnetic resonance imaging (MRI) can detect brain lesion in up to 12 to 14% of persons with epilepsy. However, for those with chronic epilepsy, MRI can detect brain lesion in 80% of the persons with epilepsy. 3-Tesla MRI scan

1950-576: The maze of corridors. Benson goes back to the computer room and finds Ross. Ross picks up Benson's gun and, after an internal struggle, shoots and kills Benson unintentionally. At one stage it was known as The Sympathetic Man . Crichton stated that this was his least favorite work. The novel was made into a film in 1974. Like his previous bestseller The Andromeda Strain , reviews for The Terminal Man were widely positive. Los Angeles Times called it "an entertaining and unsparing narrative, compressed and scientifically sound." The New Yorker called

2000-503: The novel "A fascinating, splendidly documented thriller." Life said it was "An absolutely riveting novel." John Barkham Reviews called it "A superb thriller..." and said "It will make you think-and shudder." The novel was criticized by the American Epilepsy Foundation who said it unfairly linked epilepsy with violence. Crichton's technological sci-fi premise became reality half a century later, in 2023, when

2050-411: The onset of a seizure and then use an electrical impulse to stop it. Benson's psychiatrist, Janet Ross, opposes the procedure, concerned that once the operation is complete, Benson will suffer further psychosis as a result of his person merging with that of a computer, something he has come to distrust and disdain. The surgery does initially appear to be a success, but two days after the operation, it

The Terminal Man - Misplaced Pages Continue

2100-431: The police for a considerable time, at one point confronting Ross in her home. Benson goes to a cemetery where he falls into a freshly dug grave. A procession walking towards the grave notice him in the grave with a gun and alert the authorities. Ross arrives and pleads with Benson to allow her to help him but is held back as a police helicopter shoots him as he attempts to raise his gun. The film ends with some doctors opening

2150-420: The procedure are questioned by the NPS's staff psychiatrist , Janet Ross, and later by her former teacher, Manon, an emeritus professor . Manon raises concerns that Benson is psychotic and predicts that the crimes he commits during the blackouts will not be curtailed. Ellis admits that what they are doing is not a cure for Benson's personality disorder , but will simply stimulate the brain preventatively when

2200-553: The risk for developing afebrile seizures. However, the prolonged seizure of febrile status epilepticus leads to a 9% risk for developing epilepsy. There is no clear relationship between febrile seizures and development of hippocampal sclerosis. Hippocampal sclerosis occurs with severe CA1 and less severe CA3 and CA4 neuronal loss. Experimental research has shown that N-methyl-d-aspartate (NMDA) receptor activation causes neuronal cell loss, and electrical stimulation-induced animal models of temporal lobe epilepsy duplicate

2250-569: The seizure; this reduced blood flow region may correspond to the seizure focus. Computed tomography (CT) scan is less sensitive than MRI scan for identifying small tumors, vascular malformations, cortical developmental brain malformations, and abnormalities in the medial temporal lobe. CT scan is advised in emergencies when the suspected cause of epilepsy may be intracerebral hemorrhage , brain abscess , large cerebral infarction or subdural empyema . A person who requires neuroimaging but cannot have an MRI scan due to implanted devices such as

2300-424: The surgery, whose head was shaved prior to the operation. Morris refuses a man who volunteers to have electrodes put into his brain to stimulate pleasure unchecked, because he realizes that people like Benson could potentially become addicts; he recalls a Norwegian man with schizophrenia who was allowed to stimulate himself as much as desired, to the extent that the man caused himself brain damage. Roger A. McPherson,

2350-992: The temporal lobe, for treatment of mesial temporal lobe epilepsy in 1950. In a prospective randomized controlled trial comparing anterior temporal lobectomy to medical therapy for pharmacoresistant temporal lobe epilepsy, surgery was more effective than medical therapy with 1-year seizure free outcome occurring in 58% of persons with anterior temporal lobectomy compared to 8% of persons with drug treatment. Among those with intractable mesial temporal lobe epilepsy and hippocampal sclerosis, about 70% become seizure-free after epilepsy surgery. Studies show that language dominant anterior temporal lobectomy may lead to verbal memory decline. However, study outcomes are more variable on language non-dominant anterior temporal lobectomy leading to nonverbal memory decline. Magnetic resonance-guided laser interstitial thermal therapy , stereotactic radiosurgery , and stereotactic radiofrequency ablation are surgical methods that treat epilepsy by destroying

2400-425: The test, shows his findings to Ross, who discovers that the seizures are becoming more frequent. She explains that Benson is learning to initiate seizures voluntarily because the result of these seizures is a shock of pleasure, which leads to him having more frequent seizures. Ross further discovers that, due to a clerical error by the nurses, Benson has not been receiving thorazine. She then finds out that Benson, using

2450-486: The wig and disguising himself as an orderly, has evaded the police officer assigned to guard him and escaped from the hospital. Ross goes to Benson's house, where she finds two girls who say he has a gun and possesses blueprints for the basement of the hospital, where the computer mainframe is located. Morris meets Benson's boss, who tells him that Benson disliked University Hospital because of its ultra-modern computer system, an upgraded IBM System/360 . After Benson's dogtag

2500-564: Was my film. There was the loneliness of urban America on every page. I can remember snipping my film down to match the loneliness that Hopper had captured." The Terminal Man , was not released in the UK, was successful in Japan and, according to Hodges, the film was dumped in the United States, receiving very limited screenings. "We had one terrible preview. They projected it without sound for

#945054