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Thirty patients with the syndrome of episodic compulsive eating (binge eaters) were given a neurophysiological evaluation which included a complete electroencephalogram (EEG) and a structured interview. The interview was designed to elicit 10 "neurological soft signs" (rage attacks, frequent headaches, dizziness, stomach aches, nausea, parethesias, history of convulsions, perceptual disturbances, other compulsions, and a family history of epilepsy). Afterwards, 23 patients received an adequate trial with phenytoin. The sum of the 10 neurological soft signs and the EEG (as an 11th sign) was significantly correlated with improvement. No single sign or other combination of signs was significantly a predictor of improvement. These results lend support to the thesis that in some episodic compulsive eaters, a neurophysiological substrate may be involved.
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