title: Subacute postictal aggression in patients with epilepsy.
abstract: Three men with epilepsy (age range, 38-62) who exhibited brief episodes of violent behavior during the postictal period are described. Disease duration ranged from 27 to 44 years. Patients had both complex partial seizures and secondarily generalized tonic-clonic seizures, which were refractory to antiepileptic drugs. Postictal aggression occurred shortly after a seizure and lasted 5-30 minutes. The patients displayed physically and verbally aggressive behavior toward others, but regained consciousness promptly and showed regret afterward. Interictal EEGs revealed temporal spikes, SPECT showed hypoperfusion in the temporal and frontal areas in two patients, and neuropsychological examination revealed poor frontal lobe function in two patients. Characteristics of our cases are consistent with subacute postictal aggression (SPA) reported previously. Epilepsy of prolonged duration and brain dysfunction involving a broad area including the temporal and frontal lobes may be associated with the occurrence of subacute postictal aggression.
authors.affiliation: Department of Psychiatry, National Center of Neurology and Psychiatry, Musashi Hospital, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8551, Japan. mitou-psy@umin.ac.jp
authors.forename: Masumi
authors.initials: M
authors.lastname: Ito
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Okazaki
authors.forename: Sho
authors.initials: S
authors.lastname: Takahashi
authors.forename: Reimi
authors.initials: R
authors.lastname: Muramatsu
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kato
authors.forename: Teiichi
authors.initials: T
authors.lastname: Onuma
mesh_terms: D000328:Adult; D000374:Aggression / Q000523:psychology*; D002560:Cerebrovascular Circulation / Q000502:physiology; D004569:Electroencephalography; D017029:Epilepsy, Complex Partial / Q000150:complications / Q000523:psychology*; D004829:Epilepsy, Generalized / Q000150:complications / Q000523:psychology*; D004830:Epilepsy, Tonic-Clonic / Q000150:complications / Q000523:psychology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D012640:Seizures / Q000150:complications / Q000523:psychology*; D015899:Tomography, Emission-Computed, Single-Photon