Rage and aggressive behaviour in frontal lobe epilepsy: description of a case and review of the mechanisms of aggressive behaviour in epilepsy and dementia

Roberta Di Giacomo, Giuseppe Didato, Vincenzo Belcastro, Francesco Deleo, Chiara Pastori, Dario Arnaldi, Giuseppa Jolanda Rosa, Flavio Villani

Research output: Contribution to journalArticlepeer-review

Abstract

The study of dementia and epilepsy may provide particular insight into behavioural alterations. We describe a rare case of ictal aggressive behaviour in a patient with focal epilepsy associated with a non-dominant dorso-lateral prefrontal lesion. During focal seizures, our patient showed intense agitation and anger, for a long time misinterpreted as psychogenic attacks, which disappeared after epilepsy surgery. The defined anatomical origin of such ictal emotional behaviour is not fully understood, however, the dorso-lateral prefrontal area appears to correlate less frequently with aggressiveness compared to the antero-mesial area. We describe the electroclinical data of our patient and provide a brief review of the mechanisms underlying aggressive conduct in epilepsy and dementia. An understanding of this mechanism could help to clarify the neural basis and treatment of violence associated with these and other neurological disorders. [Published with video sequence].

Original languageEnglish
Pages (from-to)419-425
Number of pages7
JournalEpileptic disorders : international epilepsy journal with videotape
Volume23
Issue number2
DOIs
Publication statusPublished - Apr 1 2021

Keywords

  • aggressiveness
  • focal cortical dysplasia
  • fronto-temporal dementia
  • prefrontal cortex
  • psychogenic non-epileptic seizures

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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