Intensive Monitoring of Epileptic Patients With a History of Episodic Aggression

Ramani, Venkat; Gumnit, Robert J.

doi:10.1001/archneur.1981.00510090064007

Cited by 16 publications

(4 citation statements)

References 9 publications

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“…We retrospectively selected 11 cases with biting and other aggressive gestures from >1,000 monitored patients, with only one of the patients acting in a violent behavior against another person. This finding is in accordance with previous studies reporting that displays of aggression are rarely performed during or after seizures (3,8,29). All the patients had chronic medically intractable focal epilepsy and were identified at two tertiary referral centres.…”

Section: Discussionsupporting

confidence: 93%

Biting Behavior, Aggression, and Seizures

et al. 2005

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Section: Discussionsupporting

confidence: 93%

Biting Behavior, Aggression, and Seizures

et al. 2005

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“…compared with seizures during wakefulness, the injury potential of seizures occurring solely during sleep is probably lower, as the bed represents a relatively safe environment (Wirrel, 2006). Ictal aggression is exceptional (Rodin, 1973;Delgado-Escueta et al, 1981;Ramani and Gumnit, 1981;Marsh and Krauss, 2000;Tassinari et al, 2005a;Reuber and Mackay, 2008). It can take the form of biting, grasping, hitting, threatening, screaming, facial expressions of anger, pushing, shoving and spitting (Marsh and Krauss, 2000;Tassinari et al, 2005a) and has been reported to occur during episodes of nocturnal epileptic wandering (Maselli et al, 1988;Schenck et al, 1989a;Guilleminault et al, 1995;Plazzi et al, 1995).…”

Section: ) Althoughmentioning

confidence: 99%

Violence in sleep

Siclari

Khatami

Urbaniok³

et al. 2010

Brain

116

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Although generally considered as mutually exclusive, violence and sleep can coexist. Violence related to the sleep period is probably more frequent than generally assumed and can be observed in various conditions including parasomnias (such as arousal disorders and rapid eye movement sleep behaviour disorder), epilepsy (in particular nocturnal frontal lobe epilepsy) and psychiatric diseases (including delirium and dissociative states). Important advances in the fields of genetics, neuroimaging and behavioural neurology have expanded the understanding of the mechanisms underlying violence and its particular relation to sleep. The present review outlines the different sleep disorders associated with violence and aims at providing information on diagnosis, therapy and forensic issues. It also discusses current pathophysiological models, establishing a link between sleep-related violence and violence observed in other settings.

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“…Two studies have directly addressed the question of whether violence may occur in association with complex partial seizures. Ramani and Gumnit (1981) selected 19 patients with a history of episodic aggressive behavior for intensive behavioral and electrophysiological monitoring for an average of 6 weeks. Ictal episodes were recorded on CCTV in 15 of the patients.…”

Section: Detailed Studies Of Epileptic Automatisms and Ictal Violencementioning

confidence: 99%

Epilepsy and Violence: Medical and Legal Issues

Treiman

1986

Epilepsia

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A possible relationship between epilepsy and violence has been debated for over a century. The debate has taken on new importance because of the increasing use of the "epilepsy defense" in criminal cases. In this review the following issues are addressed: (1) Is epilepsy more common among violent criminals and patients? (2) Is violence more common among epileptics? (3) Can directed violence or aggression occur as part of an epileptic seizure? (4) What medical and legal criteria should be used to determine whether a specific violent crime was the result of an epileptic seizure? Answers to these questions may be summarized as follows. (1) There is a two- to fourfold greater prevalence of epilepsy in prisoners than in control populations, but the prevalence is similar to the prevalence in other lower socioeconomic populations from which most prisoners come. There is no greater prevalence of epilepsy in persons convicted of violent crimes than in other prisoners matched as controls. (2) There is no evidence that violence is more common among epileptics than among non-epileptics, and no evidence that violence is more common in patients with temporal lobe epilepsy than in those with other types of epilepsy. (3) Ictal violence is rare, and when it does occur usually takes the form of "resistive violence" as the result of physical restraint at the end of a seizure, while the patient is still confused. Violence early in a seizure is extremely rare, stereotyped, and never supported by consecutive series of purposeful movements. (4) Five criteria should be used to determine if a specific violent act was the result of an epileptic seizure: a. the diagnosis of epilepsy should be established by a neurologist with special competence in epilepsy; b. the presence of epileptic automatisms should be documented by the case history and closed-circuit TV-EEG; c. aggression during epileptic automatisms should be documented on closed-circuit TV-EEG; d. the aggressive act should be characteristic of the patient's habitual seizures; and e. a clinical judgment should be made by the neurologist as to the possibility that the violent act was part of a seizure.

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Intensive Monitoring of Epileptic Patients With a History of Episodic Aggression

Cited by 16 publications

References 9 publications

Biting Behavior, Aggression, and Seizures

Biting Behavior, Aggression, and Seizures

Violence in sleep

Epilepsy and Violence: Medical and Legal Issues

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