The Aetiology of Aggression in Temporal-Lobe Epilepsy

Abstract

A retrospective case-note survey was carried out on 31 subjects admitted with temporal-lobe epilepsy to the Maudsley hospital from 1974-1983 inclusive. Fourteen aggressive subjects were compared with the non-aggressive patients on 95 organic, developmental, and social variables. Aggressive behaviour was associated with male sex, early onset of seizures, and a history of long-standing behavioural problems. Aggressive subjects had lower mean IQ scores and poorer occupational records than controls. No relationship was found between aggression and the presence of specific EEG or CAT scan findings, or a history of psychosis. The results demonstrate the complex interplay between organic and socially mediated factors underlying aggressive behaviour in temporal-lobe epilepsy.

Neurological disorders and violence: a systematic review and meta-analysis with a focus on epilepsy and traumatic brain injury

“…There were six studies in epilepsy [6,21,27,38,41,52], five case-control investigations in head injury [4,24,34,45,54], one in stroke [39], and one in Parkinson's disease [19] ( Table 2). Due to the heterogeneity of outcome measures and populations sampled, a meta-analysis of these data was not feasible.…”

“…Due to the heterogeneity of outcome measures and populations sampled, a meta-analysis of these data was not feasible. Violence was defined by self-report in eight studies (supplemented by carer information in some) [4,21,24,34,38,39,45,54] and from medical records in three investigations [6,27,41]. In order to assess psychiatric comorbidity, four studies used standardized clinical interviews [6,38,39,45] and two examined medical records [27,41].…”

“…We examined those factors that were significantly associated with violent outcomes in at least two studies per condition, which limited the analysis to epilepsy and traumatic brain injury. In epilepsy, these were a history of childhood behavioral difficulties [27,41] and comorbid psychopathology. Comorbid diagnosis of schizophrenia and learning disability/mental retardation [38] and a trend towards a history of psychosis [6] were associated with violence.…”

Aggression and Violence in Patients with Epilepsy

“…Young adult males with low or below-average intelligence, longstanding behavioral problems, fewer years of education, unemployment, and lower socioeconomic status are especially prone to aggressive behavior, but epilepsy is not clearly the relevant factor (48,49). For example, low intelligence and other more specific cognitive limitations can lead to impaired coping skills that engender aggressive or violent responses to conflicts.…”

Standard EEG in Personality and Anxiety Disorders

“…The estimates of this increase vary considerably, but is not likely to be very high, particularly when mental subnormality is excluded. Aggressive behaviours in epileptics were found to be associated with the male gender, early onset of seizures and history of long standing behavioural problems [21].…”