Neurobiology of behavior: anatomic and physiological implications related to epilepsy

Controversy exists concerning whether epileptic seizures can produce enduring alterations in neuronal function that cause interictal behavioral disturbances. Although arguments favoring the occurrence of epilepsy-induced disorders of behavior must not be presented in a way that adds to the stigmata associated with epilepsy, it is not in the best interest of epileptic patients to deny this possible relationship and overlook an opportunity to prevent or treat a major cause of disability. There is evidence to suggest that psychosocial factors cannot account for all the behavioral problems suffered by patients with epilepsy. Behavioral disturbances ascribed to antiepileptic drugs and specific structural lesions may also be due, in part, to epileptogenic mechanisms. Some interictal behavioral disturbances may actually reflect unrecognized ictal events. Most importantly, data obtained from clinical research and animal investigations suggest testable hypotheses of how recurrent epileptic seizures can alter neuronal function in ways that would predispose to specific disruptive interictal behaviors, such as aggression, depression and schizophrenia.