Biting behavior, aggression, and seizures

Carlo Alberto Tassinari, Laura Tassi, Giovanna Calandra-Buonaura, Michelangelo Stanzani-Maserati, Nicola Fini, Fabio Pizza, Ivana Sartori, Roberto Michelucci, Giorgio Lo Russo, Stefano Meletti

Research output: Contribution to journalArticle

Abstract

Purpose: To describe the semiologic features of aggressive behaviors observed in human epileptic seizures with particular reference to the act of biting a conspecific. Methods: We analyzed the biting behavior (BB) and other aggressive gestures occurring in a group of 11 patients retrospectively selected from > 1,000 patients subjected to video-EEG/SEEG monitoring for presurgical evaluation of drug-resistant seizures. Results: Patients displaying BB showed (a) a male sex pre-dominance, (b) heterogeneous etiologies and lesion locations, and (c) seizures involving the frontotemporal regions of both hemispheres. The act of biting was a rapid motor action, lasting ∼600 ms, occurring in the context of strong emotional arousal, fear, and anger, with various bodily gestures with aggressive connotation. BB was mainly a "reflexive" behavior, in that biting acts were evoked (both during and after seizures) by actions of people in close contact with the patient. The sole intrusion of the examiner's hand in the space near the patient's face was effective in triggering BB. Rarely, self-directed or object-directed biting acts were not triggered by external stimuli. Intracranial data (SEEG) obtained in one subject showed that the amygdala/hippocampal region plus the orbitomedial prefrontal cortex had to be involved by ictal activity to observe BB. Conclusions: Anatomic and electrophysiologic data in our patients suggest that a model of dual - temporal and frontal - dysfunction could account for the occurrence of ictal/postictal BB. Behavioral data suggest also that BB and related aggressive gestures can be considered as the emergence of instinctive behaviors with an adaptative significance of defense of the peripersonal space.

Original languageEnglish
Pages (from-to)654-663
Number of pages10
JournalEpilepsia
Volume46
Issue number5
DOIs
Publication statusPublished - May 2005

Keywords

  • Aggression
  • Biting
  • Epilepsy
  • Peripersonal space
  • Prefrontal cortex

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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