title: Epilepsy and homicide.
abstract: OBJECTIVE
  We report the rare case of a patient with intractable epilepsy and escalating aggression, resulting in murder, who had complete resolution of her seizures and explosive behavior following a right temporal lobectomy.
  
  
  METHODS
  We searched the available literature from 1880 to 2013 for cases of epilepsy being used as a court defense for murder and collected information regarding the final sentencing outcomes. We selected 15 papers with a total of 50 homicides.
  
  
  RESULTS
  We describe the case of a 47-year-old woman with drug-resistant right temporal epilepsy who developed increasing emotional lability, outbursts of anger and escalating violent behavior culminating in a violent murder. The patient was imprisoned while awaiting trial. In the interim, she underwent a successful temporal lobectomy with full resolution of seizures, interictal rage and aggressive behaviors. After the surgery, her charges were downgraded and she was transferred to a psychiatric facility.
  
  
  CONCLUSIONS
  The aggressive behavior associated with epilepsy has been described in the literature for over a century. A link between epilepsy and aggression has been disproportionally emphasized. These patients share some common characteristics: they are usually young men with a long history of epilepsy and lower than average intelligence. The violent act is postictal, sudden-onset, more likely to occur after a cluster of seizures and is usually related with alcohol abuse.
authors.affiliation: Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
authors.forename: Neil S
authors.initials: NS
authors.lastname: Pandya
authors.forename: Mirna
authors.initials: M
authors.lastname: Vrbancic
authors.forename: Lady Diana
authors.initials: LD
authors.lastname: Ladino
authors.forename: José F
authors.initials: JF
authors.lastname: Téllez-Zenteno
keywords: aggression; crime; epilepsy surgery; murder; temporal lobectomy