Epilepsy and Violence: When Is the Brain to Blame?

Brower, Montgomery C.; Price, Bruce H.

doi:10.1006/ebeh.2000.0069

Cited by 10 publications

(2 citation statements)

References 21 publications

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“…31 Rather, increased aggression is more validly associated with developmental or acquired brain injury (especially involving the frontal lobes), of which epilepsy can be one clinical manifestation. 32 Mr. C's presentation with paranoia and visual hallucinations could also be explained by a seizure disorder. Depending on which region of the temporal cortex is involved, temporal lobe seizures can present with the full panoply of sensory illusions and hallucinations.…”

Section: Montgomery C Brower Mdmentioning

confidence: 94%

Psychosis NOS: Search for Diagnostic Clarity

Nykiel

Baldessarini

Bower

et al. 2008

Harvard Review of Psychiatry

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Mr. C is a 27-year-old Latino father of two daughters who has a history of polysubstance abuse and antisocial behaviors and was brought to the emergency department of a community hospital after asking his girlfriend to call an ambulance. Information was provided by the patient, his girlfriend of five years, and hospital records.Mr. C was in his usual state of health until his initial presentation (as above). His girlfriend reported that over the course of several days, he had become anxious, quicker to anger than usual, and convinced that men in his neighborhood were staring at him and wanted to start trouble. In this initial emergency assessment, he did not meet inpatient level of care and was referred for outpatient services, which he utilized only twice. He had a total of three emergency room visits and two inpatient hospitalizations prior to his index assessment. Outside hospital records are without detailed descriptions, but he is consistently described as having "behavioral dyscontrol," "seizure-like activity," assaultive behavior, and agitation. He consistently denied memory of assaultive behavior, despite being declared persona non grata by one of the facilities. Between inpatient hospitalizations, he attempted to jump from a window in his fifth-floor apartment and was restrained by his girlfriend.He also denied memory of that event, and his girlfriend denied that he expressed an intention to commit suicide then or at any other time. These episodes and his subsequent lack of memory of them were described as "dissociation." Records also indicate that during his second hospitalization he experienced new memories of genital fondling by an uncle. His behaviors and lack of memory of them were attributed to posttraumatic stress disorder (PTSD).Mr. C's inpatient work-up included both electroencephalographic (EEG) and brain magnetic resonance imaging (MRI) studies that were considered unremarkable. He was treated with several psychotropic medications, including antipsychotics (haloperidol, olanzapine, ziprasidone), an anticonvulsant (divalproex), an antidepressant (fluoxetine), three benzodiazepines (clonazepam, diazepam, lorazepam), a hypnotic-antidepressant (trazodone), and a central alpha-2 adrenergic agonist (clonidine). Details such as doses, combinations, and times were not provided in his hospitaldischarge summaries. There were efforts at education, including relaxation techniques to control anxiety. Despite showing little improvement in the episodes of anxiety and dissociation, he gradually became less menacing. At discharge from his second hospitalization, his medication regimen included only clonazepam or lorazepam, clonidine and fluoxetine to treat the PTSD-like symptoms, and trazodone for sleep. Follow-up was arranged with a psychopharmacologist and psychotherapist in a day-treatment program, with recommendation of a cognitive rehabilitation program.Soon after reaching home, he again became very anxious and, within a few days, returned to the emergency department of the community hospital (the point o...

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Section: Montgomery C Brower Mdmentioning

confidence: 94%

Psychosis NOS: Search for Diagnostic Clarity

Nykiel

Baldessarini

Bower

et al. 2008

Harvard Review of Psychiatry

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“…Yung, Park, Cohen, and Garrison (2000) found that 31% of participants who had seizures also had problem behaviors such as inattention, hyperactivity, aggression, or oppositional behavior. Several researchers have reported a possible link between seizures and aggressive acts, describing violence before, during, or after a seizure in populations other than people with developmental disabilities (Blumer, Davies, Alexander, & Morgan, 2001;Brower & Price, 2000;Holzer & Baer, 1997;Marsh & Krauss, 2000;Shulman, 2000). Each of these findings suggests a possible relation between seizures and problem behavior.…”

mentioning

confidence: 99%

Descriptive Analysis of Epileptic Seizures and Problem Behavior in Adults With Developmental Disabilities

2005

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We studied possible relations between seizures and problem behavior in 3 adults with developmental disabilities. Each person was observed for between 56 and 92 days to record occurrences of seizures and problem behavior. Results of our descriptive analysis indicated an association between seizures and problem behavior for each participant. For Stan, most problem behavior occurred following absence seizures. For Tom, problem behaviors only occurred before tonic-clonic seizures but showed no relation to absence seizures. For Mick, problem behaviors began before absence seizures, but no consistent relation was established between problem behavior and tonic-clonic seizures. Findings suggest that seizures and problem behaviors can be associated, but these patterns appear to be highly idiosyncratic across individuals.

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Aggression and Violence in Patients with Epilepsy

Grisolı́a¹

2000

Epilepsy & Behavior

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Epilepsy and Violence: When Is the Brain to Blame?

Cited by 10 publications

References 21 publications

Psychosis NOS: Search for Diagnostic Clarity

Psychosis NOS: Search for Diagnostic Clarity

Descriptive Analysis of Epileptic Seizures and Problem Behavior in Adults With Developmental Disabilities

Aggression and Violence in Patients with Epilepsy

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