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Anteromesial Temporal Lobectomy for Medically Intractable Temporal Lobe Epilepsy: An Operative Study
Published on: August 15, 2025
Self injurious behavior in temporal lobe epilepsy.
D R Shakya1, P M Shyangwa, A K Pandey
1Department of Psychiatry, B P Koirala Institute of Health Sciences, Dharan. drdhanashakya@yahoo.com
JNMA; Journal of the Nepal Medical Association
|November 5, 2011
Summary
This case study highlights rare self-mutilating behavior (SMB) in temporal lobe epilepsy. Prompt diagnosis and treatment with antiepileptic and antipsychotic medications led to positive patient outcomes.
Area of Science:
- Neurology
- Psychiatry
- Epileptology
Background:
- Self-injurious behavior (SIB), also known as self-mutilating behavior (SMB), is an uncommon manifestation that can occur in patients with temporal lobe epilepsy (TLE).
- Patients often do not recall experiencing SMB during seizures, posing diagnostic challenges.
Observation:
- A 19-year-old student presented with SMB, characterized by biting his left ring finger, alongside guilty rumination, persecutory delusions, confusion, death wishes, suicidal ideation, auditory hallucinations, and thought broadcasting.
- The patient exhibited intermittent confusion regarding place and time, and episodes of self-harm were difficult to manage.
Findings:
- Electroencephalogram (EEG) confirmed left temporal lobe seizures.
- A diagnosis of 'Epilepsy and Organic Psychosis' was established.
Implications:
- This case underscores the importance of considering TLE in the differential diagnosis of unexplained self-mutilating behavior, especially when accompanied by psychotic symptoms.
- Effective management involves a combined therapeutic approach using antiepileptic and antipsychotic medications.
