The nature and management of aggression in epilepsy

Minor episodes of aggressive behavior are relatively common in some populations of patients with epilepsy. However, they are probably no more common than in populations who are socially disadvantaged or who have brain damage. The confusion that commonly follows seizures can lead to apparently aggressive behavior. Rarely, the seizure itself may lead to directed aggression; very rarely does it lead to murderous attacks. Although post-ictal psychotic aggression is usually not severe, when it is driven by prominent delusions and hallucinations, it can result in self-destructive acts or serious violence. Clearly, however, it is quite unfair to globally classify epileptics as aggressive, and the time has come to abandon this stereotype.