Abstract

AGGRESSION IN INTRACTABLE EPILEPSY

Author(s): Anupama M1, Babool Raja2, Vikas Dhingra3

ABSTRACT: BACKGROUND: Increased rate of aggression in patients with epilepsy is well known. However this phenomenon is relatively less studied systematically. AIMS: To study the prevalence of aggression in medically intractable complex partial epilepsy and its association with Electroencephalograph (EEG), Magnetic Resonance Imaging (MRI) variables. MATERIALS AND METHODS: Forty random sample of patients with medically intractable epilepsy were assessed for frequency and severity of aggression on Overt aggression scale. The relationship between EEG, MRI variables and aggression were computed. RESULTS: Verbal aggression was present in 35(87.5%), physical aggression against other people was present in 13(32.5%), physical aggression against objects was present in 10(25%), physical aggression against self was present in 6(15%) patients. No significant correlation of aggression was found with age at onset, duration of seizures, frequency of seizures, presence of febrile seizures, presence & laterality of temporal focus, presence of generalized discharges on EEG and presence of MTS or other abnormalities on MRI. There was significant negative correlation between use of carbamazepine and physical aggression against self (p=0.014). CONCLUSION: High rates of aggression are present in patients with intractable epilepsy, and it is probably related to generalize subtle brain damage than any focal damage, interacting with the effects of seizures, interictal changes associated with epilepsy, effects of AED and adverse psychosocial events.