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Updated: May 27, 2026
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
Abstract:
Self-injurious behavior (SIB) or self-mutilating behavior (SMB) is rare but can occur in temporal lobe epilepsy. Such a behavior during seizures is not usually recalled by patient. Here is a case with self mutilating behavior in left temporal lobe epilepsy, presented because of its rare manifestation and diagnostic dilemma. A 19 year old unmarried Muslim student presented to emergency with SMB, guilty rumination and a persecutory delusion. The patient was intermittently confused about place and time. In subsequent assessments, he was found harboring death wishes and suicidal ideation. He transiently had auditory hallucination and thought broadcasting. He episodically tried to harm himself by severely biting only his left ring finger. It was difficult to influence him during such episodes. EEG revealed left temporal lobe seizure. Diagnosis of 'Epilepsy and Organic Psychosis' was made. The patient responded well to Antiepileptic and Antipsychotic medications.
Insights
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.
