Disruptive behavior problems

William B. Svoboda

doi:10.1017/CBO9780511545092.037

35 - Disruptive behavior problems

from Part III - Behavior problems

Published online by Cambridge University Press: 26 October 2009

William B. Svoboda

Book contents

Get access

Summary

Behavior disorders occur in 28.6% of children with uncomplicated seizures and in 58.3% of children with seizures and other brain dysfunctions, according to parent and teacher reports (Dunn & Austin, 1998). Children struggling with the problem of epilepsy often display acting-out behaviors. They may seem moody or they may display erratic, variable, unpredictable behaviors. Some children seem irritable, exhibiting angry outbursts of temper. Their attention spans may seem shortened. Some children are anxious and jittery, with hyperactive behavior.

Rebellious, resentful attitude

The child, especially in adolescence, may try to escape from the parents' overly restrictive demands through rebellion. Some children may be so discouraged that they lash out angrily. Some may try to blame others for rejecting them because of the seizures. They seem angry, hostile, and aggressive. The school record may be one of absenteeism. Some may develop frank antisocial and delinquent behavior. Such children need intensive guidance and counseling so that they may finally accept the epilepsy and develop a better self-concept and therefore move ahead.

Impulse-control problems

Over the years, impulse-control problems have emerged with a variety of names, including episodic dyscontrol syndrome, intermittent explosive disorder, and “rage” reactions. Impulse-control problems may be seen in personality disorders, with cerebral damage as with seizure activity, structural loss, antiepileptic drugs, and social deprivation.

The possibility of an ictal basis for aggressive symptoms as part of the interictal period, in which aggressive behavior may follow one or more serial unrecognized seizures, is debated.

Information

Type: Chapter
Information: Childhood Epilepsy
Language, Learning and Behavioural Complications
, pp. 533 - 546

DOI: https://doi.org/10.1017/CBO9780511545092.037 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Bach-y-Rita, G., Lion, J. R., Climent, C. E., et al. (1971). Episodic dyscontrol: a study of 103 violent patients. Am. J. Psychiatry 127: 1473–8CrossRef Google Scholar

Blanchet, P. & Frommer, G. P. (1986). Mood changes preceding epileptic seizures. J. Nerv. Ment. Dis. 174: 471–6CrossRef Google Scholar

Blumer, D. (1967). The temporal lobes and paroxysmal behavior disorders. Z. Psychiol. 51: 273–85Google Scholar

Caplan, R., Arbelle, S., Guthrie, D., et al. (1997). Formal thought disorder and psychopathology in pediatry primary generalized and complex partial epilepsy. J. Am. Acad. Child Adolesc. Psychiatry 36: 1286–94CrossRef Google Scholar

Cavazzuti, G. B. (1980). Epidemiology of different types of epilepsy in school age children of Modena Italy. Epilepsia 21: 57–62CrossRef Google Scholar PubMed

Chengappa, K. N., Ebeling, T., Kang, J. S., et al. (1999). Clozapine reduced severe self-mutilation and aggression in psychotic patients with borderline personality disorder. J. Clin. Psychiatry 60: 477–84CrossRef Google Scholar

Davis, L. L., Ryan, W., Adinof, B., et al. (2000). Comprehensive review of the psychiatric uses of valproate. J. Clin. Psychopharmacol. 20 (suppl 10): 1–17CrossRef Google Scholar PubMed

Delgado-Escueta, A. V., Mattsen, R. H., King, L., et al. (1981). Special Report: the nature of aggression during epileptic seizures. N. Engl. J. Med. 305: 711–16CrossRef Google Scholar PubMed

Dunn, D. W. & Austin, J. K. (1998). Behavioral aspects of pediatric epilepsy. In Psychiatric Issues in Epilepsy, ed. A. B. Ettinger & P. B. Hermann, pp. New York: Lippincott Williams & Wilkins

Fenwick, P. (1981). EEG studies. In Epilepsy and Psychiatry, ed. E. M. Reynolds & M. R. Trimble, pp. 42–63. New York: Churchill Livingstone

Fenwick, P. (1997). Episodic dyscontrol. In Epilepsy: A Comprehensive Review Textbook, ed. J. Engle & T. A. Pedley, pp. 2767–74. Philadelphia: Lippincott-Raven

Ferguson, S. M., Ryaport, M. & Corrie, W. S. (1980). Mechanisms of aggressive behavior in patients with temporal-limbic epilepsy. In Advances in Epileptology, The Xth Epilepsy International Symposium, ed. J. A. Wada & J. K. Penry, p. 527. New York: Raven Press

Gastaut, H., Morin, G. & Lesevre, N. (1955). Etude du comportement des epileptiques sycho-motoeurs dans I'intervalle de leurs crises. Ann. Med. Psychol. 1–27

Gerad, M. E., Spitz, M. C., Towbin, J. A., et al. (1998). Subacute post-ictal aggression. Neurology 50: 384–8CrossRef Google Scholar

Glaser, G. (1967). Limbic epilepsy in childhood. J. Nerv. Ment. Dis. 141: 392–7Google Scholar

Henry, A. S., Berkovic, S. F., Wrennall, J. A., et al. (1997). Temporal lobe epilepsy in childhood: clinical, EGG and neuroimaging findings and syndrome classification in a cohort with new-onset seizures. Neurology 49: 960–63Google Scholar

Hermann, B. P., Black, R. B. & Chabria, S. (1981). Behavioral problems and social competence in children with epilepsy. Epilepsia 22: 703–10CrossRef Google Scholar PubMed

Hermann, B. P., Schartz, M. S., Whitman, S., et al. (1980). Aggression and epilepsy: seizure-type comparisons and high risk variablesEpilespia 22: 691–8CrossRef Google Scholar

Herzberg, J. & Fenwick, P. B. C. (1988). The etiology of aggression in temporal-lobi epilepsy. Br. J. Psychiatry 153: 50–5CrossRef Google Scholar

Holmes, G. L. (1987). Psychosocial factors in childhood epilepsy. In Diagnosis and Management of Epilepsy in Children, pp. 112–24. Philadelphia: W. B. Saunders

Juhasz, C., Behen, M. E., Muzik, O., et al. (2001). Bilateral prefrontal temporal neocortical hypometabolism in children with epilepsy and aggression. Epilespia 42: 991–1001CrossRef Google Scholar PubMed

Kanemoto, K., Kawasaki, J. & Mori, E. (1999). Violence and epilepsy: a close relation between violence and post-ictal psychosis. Epilespia 40: 107–9CrossRef Google Scholar

Kaufman, K. R., Kugler, S. L., Sachdeo, R. C., et al. (1999). Tiagabine in the management of post-encephalitic epilepsy and impulse control disorders. Epilespia 40 (suppl 7): 57Google Scholar

Keating, L. E. (1961). Epilepsy and behavior disorder in school children. J. Ment. Sci. 107: 161–80CrossRef Google Scholar

Lewin, J. & Sumners, D. (1992). Successful treatment of episodic dyscontrol with carbamazepine. Br. J. Psychiatry 161: 261–2CrossRef Google Scholar PubMed

Lewis, D. O. (1976). Delinquency, psychomotor epileptic symptoms and paranoid ideation: a triad. Am. J. Psychiatry 133: 1395–8Google Scholar PubMed

Lewis, D. O., Pincus, J., Shanok, S., et al. (1981). Psychomotor epilepsy and violence in a group of incarcerated adolescent boys. Am. J. Psychiatry 139: 882–7Google Scholar

Lindsay, J. (1981). The long-term outcome of temporal lobe epilepsy in childhood. In Epilepsy and Psychiatry, ed. E. H. Reynolds & M. R. Trimble, pp. 185–215. London: Churchill Livingstone

Maletzky, B. M. (1973). The episodic dyscontrol syndrome. Dis. Nerv. Syst. 34: 180–84Google Scholar PubMed

Mendez, M. F., Doss, R. C. & Taylor, J. L. (1993). Interictal violence in epilepsy: relationships to behavior and seizure variables. J. Nerv. Ment. Dis. 181: 566–9CrossRef Google Scholar

Neidermeyer, E. (1990). Psychological-psychiatric aspects. In The Epilepsies, Diagnosis and Management, pp. 213–81. Baltimore, MD: Urban & Schwarzenberg

Nuffield, E. J. A. (1961). Neuro-physiology and behavior disorders in epileptic children. J. Ment. Sci. 107: 438–58CrossRef Google Scholar PubMed

Ounsted, C., Lindsay, J. & Norman, R. (1968). Biological Factors in Temporal Lobe Epilepsy. London: Spastics Society and Heinemann

Pond, D. A. & Bidwell, B. H. (1954). Management of behavior disorders in epileptic children. Br. Med. J. 11: 1520CrossRef Google Scholar

Rodin, E. A. (1973). Psychomotor epilepsy and aggressive behavior. Arch. Gen. Psychiatry 28: 210–13CrossRef Google Scholar PubMed

Saint-Hilaire, J. M., Gilbert, M., Bouvbier, G., et al. (1980). Epilepsy and aggression: two cases with depth electrode studies. In Epilepsy Updated: Causes and Treatment, ed. P. Robb, pp. 145–75 Chicago: Year Book Medical Publishers

Schacter, S. C. (2001). Aggressive behavior in epilepsy. In Psychiatric Issues in Epilepsy, ed. A. B. Ettinger & A. M. Kanner, pp. 201–14. Philadelphia: Lippincott Williams & Wilkins

Sillinpaa, M. (1973). Medico-social prognosis of children with epilepsy. Acta Paediatr. Scand. Suppl. 237: 6–104Google Scholar

Stone, J. L., McDaniel, K. D., Hughes, J. R., et al. (1986). Episodic dyscontrol disorders and paroxysmal EEG abnormalities: successful treatment with carbamazepine. Biol. Psychiatry 21: 208–12CrossRef Google Scholar PubMed

Stores, G. (1971). Cognitive function in children with epilepsy. Dev. Med. Child Neurol. 13: 390–92CrossRef Google Scholar PubMed

Svoboda, W. B. (1979). Emotional and behavioral consequences of epilepsy. In Learning About Epilepsy, pp. 157–84. Baltimore, MD: University Park Press

Szondi, L. (1963). Schicksalsanalytische Therapie. Bern: Hans Huber

Trieman, D. M. (1986). Epilepsy and violence: medical and legal issues. Epilepsia 27: 77–104CrossRef Google Scholar

Weisbrot, D. M. & Ettinger, A. B. (1998). Psychiatric aspects of pediatric epilepsy. Primary PsychiatryJune: 51–67

Accessibility standard: Unknown

Why this information is here

This section outlines the accessibility features of this content - including support for screen readers, full keyboard navigation and high-contrast display options. This may not be relevant for you.

Accessibility Information

Accessibility compliance for the PDF of this book is currently unknown and may be updated in the future.