Aggressive ictal behavior. 2However, this behavior is rare in the ictal state.

Aggressive ictal behavior Aggression is seen in a minority of people with 5 Aggressive behavior and violence Aggressive behavior is very rare as an ictal phenomenon, while it may be seen in the context of postictal confusion. A case report of ictal violence cited by Fazel and colleagues was published by Shih et al. While violent behaviors are sometimes associated with ictal or postictal states, in-terictal aggression is commonly related to cognitive and behavioral disturbances secondary to brain dys-function that may also underlie epileptogenesis (3). Despite this, it is encouraged to provide your dog with mental stimulation (e. Jan 1, 2019 · We report a case of a 52-year-old man with drug-resistant temporal lobe epilepsy, with post-ictal violent aggressive behaviors. The purpose of this study was to determine the presence and severity of anxiety related behaviors in dogs with IE compared to other medical populations, and to determine if behavioral changes were associated with seizure control. Apr 27, 2005 · Methods: We analyzed the biting behavior (BB) and other aggressive gestures occurring in a group of 11 patients retrospectively selected from >1,000 patients subjected to video-EEG/SEEG monitoring for presurgical evaluation of drug-resistant seizures. Jun 1, 2007 · The relationship between violence and epilepsy has long been a matter of interest. Interactive behavior with the ability to respond to visual and verbal stimuli is also rare in complex partial seizures. Furthermore, previous post-ictal behavior, especially agitation (restlessness or agitation persistent >2. The idea of such "interictal behavior disorders Sep 22, 2024 · Explore common post-seizure behaviors, their causes, and management strategies. These signs and symptoms are common, can be quite debilitating, and can have a continued impact long after the seizure has ended. Medical and emergency staff require careful training to manage behaviors associated with postictal delirium and psychosis in order to protect patients while their confusion Apr 23, 2024 · Depending on the chronological relationship with seizures, aggression in people living with epilepsy (PLWE) can be categorized as preictal, ictal, postictal, and interictal. The blindness usually resolves after your dog fully recovers from the seizure. It usually lasts between 5 and 30 minutes, but sometimes longer in the case of larger or more severe seizures, and is characterized by drowsiness, confusion, nausea, hypertension, headache or migraine, and other disorienting symptoms. Feb 1, 2000 · Recurrent episodes with interictal affective aggression are a rare but well-recognized problem in patients with temporal lobe epilepsy. They can help manage these feelings and improve your life. During focal seizures, the patient showed intense agitation and anger, for a long time misinterpreted as psychogenic attacks, which disappeared after epilepsy surgery. The violent outbursts were traumatizing f … To the Editor: People with intellectual disability often exhibit various behavioral problems, which are referred to as “challenging behaviors. Methods Six patients from our database of 1300 were assessed. A seizure often has four distinct phases: Prodromal Symptoms, Auras, Ictal and Postictal Stages. It can also manifest as an episodic event independent of observable seizures, making it inter ictal. Three men with epilepsy (age range, 38–62) who exhibited brief episodes of violent behavior during the postictal period are described. The post-ictal phase is an important part of a seizure episode in dogs, occurring immediately after the seizure activity ceases. There are several types and patterns of aggressive behavior toward self and others. The concept of postictal Dec 5, 2021 · Is aggression a symptom of epilepsy? Aggressive and violent behaviors have also been associated with epilepsy, especially temporal or frontal lobe seizures. Jan 1, 2013 · Patients with temporal lobe epilepsy (TLE) often have a brief postictal state characterized by confusion and disorientation. 5 h after a seizure, not defined as psychosis), and psy-chosis (previous ictal, interictal, or postictal psychosis), as well as the use of antipsychotics at the start of EMU admission, were recorded. These range from behaviors associated with underlying brain dysfunction to postictal delirious and psychotic states and rare cases of ictal aggression. Medical and emergency staff Oct 28, 2009 · Shih JJ, LeslieMazwi T, Falcao G, Van Gerpen J. Researchers have proposed that there are syndromes of interictal behavior changes that can occur in people with epilepsy. Patients with temporal lobe epilepsy (TLE) often have a brief postictal state characterized by confusion and disorientation. It is possible to divide aggression associated with temporal lobe pathology into 3 groups: ictal, post-ictal and inter-ictal behavior. During Jan 1, 2014 · Aggressive behavior is very rare as an ictal phenomenon, while it may be seen in the context of postictal confusion. Oct 21, 2009 · Aggressive ictal behavior is generally believed to not be goal directed. Directed aggressive behavior in frontal lobe epilepsy: a video-EEG and ictal SPECT case study. Aggressive ictal behavior is generally believed to not be goal directed. We describe two male Nov 4, 2025 · The postictal phase is the period of time immediately following a seizure. Aug 25, 2023 · The study of epilepsy may provide remarkable insight in the neural mechanisms of aggressive behavior. It may offer information that could be helpful in the definition of the epileptogenic zone and its lateralization. Medication withdrawal may lead to a new seizure type for an individual patient, including ictal aggressive behavior. Animal studies indicate that stimulation of the lateral and medial hypothalamus result in different types of aggression (6). An individual may be hurt or the environme t may be damaged because they are in the path of the person's movement. Postictal aggression usually occurs while the patient is in a confusional state and is manifested as resistive violence when attempts are made to restrain the patient [1]. Disease duration ranged from 27 to 44 years. Its causes in cats can be complex, both in These range from behaviors associated with underlying brain dysfunction to postictal delirious and psychotic states and rare cases of ictal aggression. The ictal period is the seizure itself; the interictal period is the time Apr 19, 2002 · While such aggressive behavior is rare, it is important to recognize the possibility, especially if the dog is large and there are children in the household. Jul 3, 2025 · The association between epilepsy and violent behavior, although scientifically unfounded, has persisted in legal, psychiatric, and public discourse for over a century. Oct 28, 2023 · Objective: The principal objective aims to assess a possible relationship between epilepsy and aggressive behavior. Get free rules, notes, crosswalks, synonyms, history for ICD-10 code R45. . Frontal lobe seizures may manifest bizarre behaviors such as thrashing, kicking, genital manipulation, unusual facial expressions, and articulate vocalizations. 1. They are referred to as episodic dyscontrol or, more precisely, as intermittent explosive disorder (IED). In Dec 27, 2011 · In epilepsy, violent behavior may occur during seizures (ictal violence) or in between the seizures (interictal violence). Learn more about the symptoms and how they help direct epilepsy treatment. During this period, resistive violence can occur. Fits of ictal rage, although infrequent, are characterized by poor awareness, l Jun 1, 2000 · Violence has been associated with epilepsy. Post-ictal confusion is characterised by impaired awareness/consciousness and diffuse EEG slowing without ictal discharges. These changes can show up as being more aggressive, changing in personality, or acting differently. Jun 1, 2005 · Request PDF | Biting Behavior, Aggression, and Seizures | To describe the semiologic features of aggressive behaviors observed in human epileptic seizures with particular reference to the act of Understanding aggressive or violent behavior in epilepsy requires classification by seizure phase—ictal, postictal, or interictal. These episodes are usually brief and common after complex partial or generalised tonic-clonic seizures. Aggression Ictal aggression and violence are frequently nondi-rected and stereotyped. Jul 15, 2025 · If someone has had epileptic episodes for a long period of time, these episodes can sometimes convert into postictal psychosis, which is a type of psychosis that is characterized by auditory and visual hallucinations, delusions, paranoia, affective change, and aggression including violent behavior that takes place after a seizure episode. Some dogs with epilepsy exhibit changes in physical behaviour or mental ability. It may occur during seizures (ictal violence), between them (inter-ictal violence), or directly after them (postictal violence). A large survey of several thousand seizures documented on video-EEG reports an incidence of 1 out of 1000 seizures with aggressive behaviors [36]. Aggressive behavior is popularly thought to be frequently associated with the epileptic character and particularly temporal lobe disorders. Plotnik (7) divided aggression based on the relationship between stimulus and behavior and argued against attributing aggressive behaviors to direct involvement of specific anatomical sites. A classification scheme based on the development of psychopathological features observed during the prodromal, ictal, peri-ictal, and interictal periods provides a framework to discuss treatment alternatives. , who claimed that the violence was directed and interactive; potential significant adverse legal ramifications of such ictal behavior were mentioned [7]. Jan 28, 2023 · The study of epilepsy may provide remarkable insight in the neural mechanisms of aggressive behavior. 1 The management of aggression in these patients involves both behavior therapy 2 and medications. Violent behavior among patients with epilepsy can be categorized into peri-ictal violence (preictal, ictal, and postictal), which occurs around the time of a seizure attack, and interictal violence, which has less of a temporal relationship with a seizure attack [2]. It typically emerges after a lucid interval of hours or days after the last seizure. 1 Aggressive and violent behaviors have also been associated with epilepsy, especially temporal or frontal lobe seizures. Neurology 2009; 73;1804–1806. These phases are associated with distinct pathophysiological mechanisms and behavioral manifestations, as emphasized by others [11,12,15]. Aggressive behavior occurs most frequently during the postictal period. Most fr quently, aggression occurs in the post-ictal phase and is not directed. Postictal violent | Find, read and cite all the research Oct 21, 2009 · Frontal lobe seizures may manifest bizarre behaviors such as thrashing, kicking, genital manipulation, unusual facial expressions, and articulate vocalizations. A world you’re probably familiar with. Violent behavior may also be observed during a period of postictal Feb 1, 1998 · Objective To address clinical features of subacute postictal aggression, we examined aggressive behavior beginning hours to days after the acute confusional postictal period. Antiepileptic drugs (AEDs) have many benefits but also many side effects, including aggression, agitation, and irritability, in some patients with epilepsy. Clearly, however, it is quite unfair to globally classify epileptics as aggressive, and the time has come to abandon this stereotype. The first patient's postictal state included an intense urge to Nov 10, 2019 · We report a case of a 52-year-old man with drug-resistant temporal lobe epilepsy, with post-ictal violent aggressive behaviors. However a thorough review of the literature fails to reveal any clear-cut evidence for this belief during inter-ictal periods. Dec 2, 2005 · Ictal aggression is extremely rare, but does occur with temporal lobe seizures and probably can lead to injury to the patient or others. This review describes the differential diagnosis of violent acts in epilepsy and the features that can be used to evaluate these behaviors. , try intelligent or smart dog toys), physical exercise and a calm environment. The violent outbursts were traumatizing for his family, and lead to multiple emergency department presentations as well as conflicts Mar 13, 2010 · In regards to seizures, aggressive behaviors can be seen in the post-ictal phase, following a seizure. Secondarily, we intend to study how epilepsy relates to criminal liability Oct 1, 2009 · Aggressive behavior during the ictal 33 or postictal state 34 in some PWEs, particularly those with frontal lobe epilepsy, can lead to potentially fatal interactions. The brain changes a lot after a seizure, which affects how we act and think. How will the vet diagnose a dog with psychomotor seizures? If you are concerned that your dog is experiencing seizure activity at home, schedule an appointment with your veterinarian. This article offers a comprehensive summary of current understanding of aggressive behaviors in patients with epilepsy, including an evidence-based review of aggression during AED treatment. Psychosis includes delusions, auditory and visual hallucinations, mood changes, and aggressive behavior. However, the links between violent behaviors and epilepsy involve multiple factors. 1 Firstly, violent behavior can be associated with underlying brain dysfunction, postictal confusion or psychosis, and sometimes with ictal aggressions. Postictal aggression occurred shortly after a seizure and lasted 5–30 Sometimes, post-ictal dogs are uncoordinated and may have difficulty standing on slippery floors. Postictal violent outbursts would occur 3–4 times per year following clusters of seizures or generalized tonic–clonic convulsions. Monitoring the duration and severity of post-ictal changes allows you to differentiate between expected post-seizure behavior and potentially life-threatening complications that necessitate immediate veterinary intervention. The postictal state is the altered state of consciousness after an epileptic seizure. However, this claim was criticized in a commentary [8]. Behavioural changes Behaviour changes can be seen in the pre-ictal and post-ictal phases (before and after a seizure). The fact that he is partially amnestic to the ictal events points toward a complex partial event with possible spread to mesial temporal structures. eizure episode. Aggression at the onset, during the middle or terminal part of the epileptic seizure toward inanimate objects or another person was observed in seven cases. Dec 5, 2021 · Is aggression a symptom of epilepsy? Aggressive and violent behaviors have also been associated with epilepsy, especially temporal or frontal lobe seizures. Abstract Anxiety related behaviors have been reported in humans diagnosed with idiopathic epilepsy (IE) and such traits may be altered depending on seizure phase. In this setting, it has been ob-served that aggressive behaviors often occur in response to a minimally unpleasant stimulation and particularly in response to the attempt to restrain the patient (10). Postictal violent outbursts would occur 3-4 times per year following clusters of seizures or generalized tonic-clonic convulsions. Data was obtained 2. Behavioral data suggest also that BB and related aggressive gestures can be considered as the emergence of instinctive behavior … ICD 10 code for Violent behavior. While rare cases of aggressive behavior in people with epilepsy (PWE) may arise from specific clinical contexts—such as postictal confusion or psychiatric comorbidities—epilepsy itself is not a predictor of violence or Cognitive Dysfunction House Soiling Destructive Behavior Cats that Lick Too Much Help! My Cat's a Killer; What Can I Do? Choosing and Caring for Your New Cat Video: Managing Destructive Scratching Aggression, defined as hostile or violent behavior intended to dominate or intimidate another individual, is a fairly common behavioral problem in cats. They may also appear to be blind and bump into walls or furniture. About 23% of post-ictal psychotic episodes involved violence directed toward others, and 7% involved suicidal behavior. Three different types of aggressive behaviors have been distinguished on the basis of their relation to the seizure event: interictal, ictal, and postictal aggression (3–5). Jun 17, 2010 · The postictal period is defined by changes in behavior, motor function, and neuropsychological performance that last until the return to a presumed baseline. This may be true, but the available evidence does not clearly support this view. Understanding Epilepsy Main Menu Table of Contents: What is a Seizure? What happens during a seizure? Before the Seizure: Prodromal Phase (Predome) During the Seizure: Early Ictal and Ictal Phases After the Seizure: Post Ictal Phase Seizure Symptoms What is a Seizure? A seizure is an electrical disturbance that interferes with normal brain function. Partial seizures in dogs that affect a particular portion of the brain responsible for regulating aggression may be also a contributing factor to aggression and aberrant behaviors. We review risk factors for postictal delirium and psychosis and management of agitated and confused behaviors in patients after seizures. This review describes the differential diagnosis of violent acts in epilepsy and the features that can be used to We report a case of a 52-year-old man with drug-resistant temporal lobe epilepsy, with post-ictal violent aggressive behaviors. 1 Aggressive and violent behaviors have also been associated with epilepsy, especially temporal or frontal lobe seizures. 3. For some pets, they may display Nov 1, 2019 · PDF | We report a case of a 52-year-old man with drug-resistant temporal lobe epilepsy, with post-ictal violent aggressive behaviors. This review describes the differential diagnosis of violent acts in epilepsy and the features that can be used to Apr 27, 2005 · Episodes of aggressive behavior related to epilepsy have gained considerable attention in the medical literature because they represent an important social as well as clinical problem (1,2). While many owners focus on the seizure itself, the recovery phase is crucial to understanding the full impact of epilepsy on a dog’s health. Example of concerning behaviors after a seizure Concerning signs or behaviors after a seizure include: Remaining unconscious A seizure that lasts over 3 Epilepsy is often complicated by behavioral symptoms including aggression or various psychiatric disorders. Postictal violent outbursts would occur 3–4 times per year following clusters of seizures or generalized tonic–clonic Violence has been associated with epilepsy. A rare case of ictal aggressive behavior in a patient with focal epilepsy associated with a non-dominant dorsal-lateral prefrontal lesion is here described. 2 However, this behavior is rare in the ictal state. , who claimed that the violence was directed and interactive; potential significant adverse legal ramifications of such ictal Apr 12, 2020 · Kanner emphasized that although post-ictal fear and confusion—which are quite common—can lead to aggressive behavior in someone with epilepsy, this aggressive behavior is not post-ictal psychosis. Nov 16, 2023 · This case highlights a rare symptom, ictal aggression, associated with a temporal lobe lesion. One third of patients with Jun 6, 2025 · Any aggression that is uncharacteristic and severe should also be addressed promptly. During Aggressive behavior occurs most frequently during the postictal period. This widespread medical view lost general acceptance among experts in the 1990s after several large-scale studies showed that aggressive phenomena can arise during epileptic seizures, but are extremely rare. 2 However, this behavior is rare in the ictal state. This treatable disorder is associated with serious morbidity and mortality. Jun 1, 2007 · The episodes of aggressive behavior during the postictal period exhibited by the three persons described here have several features in common. Aggression in epilepsy can be classified in relation to its temporality with the fits, as pre-ictal, ictal or post-ictal. ” Aggression is among the commonest of these, affecting about 7% of this population. A large survey of several thousand seizures documented on video-EEG reports an incidence of 1 out of 1000 seizures with aggressive behaviors [36] . It's very important to monitor your dog's behavior after a seizure. 6. We describe two male patients with left TLE and unusual postictal states that led to unfortunate outcomes. We report the case of a Feb 12, 2025 · Post-ictal signs are the behaviors and symptoms that appear after a dog has a seizure. Ictal and postictal aggression has been reported especially when the patient is exhibiting undirected automatisms in a confused postictal state (4). There are several possible reasons for such aggression. g. Postictal aggression occurred shortly after each seizure and lasted 5–30 minutes. 3 Various medications, such as lithium, anticonvulsants, and Aug 30, 2025 · Postictal psychosis is a serious condition that can arise after seizures. More than 70% of people with epilepsy report post-ictal (after-seizure) complications, including confusion, fear, exhaustion, headache, emotional reactivity, memory problems and behavioral changes. Behaviour symptoms associated with epilepsy may be pre-ictal, ictal, post ictal or inter ictal [16]. Learn more about tonic clonic seizures, temporal lobe epilepsy, and more. Epilepsy and violence can be connected for different reasons. Usually this post-ictal behavior begins to resolve within a few hours after the seizure and the dog gets back to normal. A 2005 study found that both violence and aggression are more common in post-ictal psychosis than post-ictal confusion. The concept of postictal Oct 13, 2016 · “How do you treat aggressive behavior that accompanies brain damage?” Aggressive behavior often occurs in the setting of neuropsychiatric disorders. Mar 25, 2025 · Welcome to the world of ictals and postictals. Aggressive and violent behaviors have also been asso- ciated with epilepsy, especially temporal or frontal lobe seizures. Aggression during ictal activity is rare and usually random and undirected. This study demonstrates a rare case of directed and interactive aggressive verbal and physical behavior during frontal lobe seizures. All three types of aggression The approach to the treatment of psychosis, irritability, and aggression in patients with epilepsy (PWE) is often dependent on their temporal relations to seizure occurrence. This phase can last from a few minutes to several hours, during which the dog may display behaviors such as disorientation, restlessness, pacing, excessive thirst, temporary blindness, and even aggression. The purpose of this systematic review was to quantify the occurrence of postictal signs and symptoms, along with their frequency and duration in persons with epilepsy. Anatomic and electrophysiologic data in our patients suggest that a model of dual--temporal and frontal--dysfunction could account for the occurrence of ictal/postictal BB. Kousuke Kanemoto Post-ictal aggression is most often a response to a bystander or first responder. Variations on the theme Not all generalized seizures follow this Oct 21, 2009 · Frontal lobe seizures may manifest bizarre behaviors such as thrashing, kicking, genital manipulation, unusual facial expressions, and articulate vocalizations. In a study of ictal aggression, only 13 out of 5400 patients were found to have aggressive behavior on closed-circuit television, and only 5 of them had a history of harming another person (Delgado-Escueta et al. Some last an hour; others can last for days. The postictal period has many physical, behavioral, and cognitive manifestations associated with it. 2However, this behavior is rare in the ictal state. 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. Interactive behavior with the ability to respond to visual and verbal stim- uli is also rare in complex partial seizures. Postictal behaviors and symptoms often require special assessment and treatment. Aggressive ictal behavior is generally be- lieved to not be goal directed. We would like to show you a description here but the site won’t allow us. Societal biases associating aggression with epilepsy can heighten stigma, reducing the quality of life for PLWE. Hill and Watterson (1942) report that aggressive behavior was found nearly three times as frequently among first degree relatives of aggressive psychopaths as amongst those of "inadequate" psychopaths, but they did not distinguish between explosive rage and other types of aggression. Jun 18, 2010 · Postictal behaviors and symptoms often require special assessment and treatment. Patients had both complex partial seizures and secondarily generalized tonic–clonic seizures, which were refractory to antiepileptic drugs. The belief that epilepsy is linked with violent behavior acquired a highly stigmatizing value in the late 19th century on the basis of degenerative theory. Jul 8, 2023 · Post-ictal: The post-ictal stage occurs once the seizure has passed and can involve confusion and abnormal behavior. Aggressive behaviour may occur and is usually undirected or resistive and the patient is likely to be amnesic for the event. We report the case of a patient with seizures manifesting with interactive directed aggressive behaviors. However, this behavior is rare in the ictal state. It occurs when abnormal electric signals Nov 24, 2009 · Directed aggressive behavior in frontal lobe epilepsy: a video-EEG and ictal spect case studyMeSH terms Agonistic Behavior / physiology* Electroencephalography / methods* Epilepsy, Frontal Lobe / diagnostic imaging* Epilepsy, Frontal Lobe / physiopathology* Humans Male Tomography, Emission-Computed, Single-Photon / methods* Young Adult May 22, 2025 · Behavior changes during the post-ictal (post-seizure) period Once the psychomotor seizure is over, the dog may exhibit aggression, depression, or exhaustion. Oct 1, 2002 · The approach to the treatment of psychosis, irritability, and aggression in patients with epilepsy (PWE) is often dependent on their temporal relations to seizure occurrence. The stakes are high for accurate diagnosis, as ictal aggression can cause unique distress among people with epilepsy, including social stigma and potential legal ramifications. Some rare cases of ictal aggressi … 4 Association between epileptic seizure and criminal acts Delgado et al. Is Aggression Related To Epilepsy? It is now believed that most people with epilepsy are no more likely than others to act aggressively. Learn to recognize and respond to unusual post-ictal symptoms effectively. 2002). Aggression in epilepsy can be classified in relation to its temporality with the fits, as pre ictal, ictal or post ictal. Less common postictal behaviors include wandering and violence — both reactive and spontaneous. Oct 1, 2010 · The belief that epilepsy is linked with violent behavior acquired a highly stigmatizing value in the late 19th century on the basis of degenerative theory. 302 The Bulletin illness in this cultivated family. The postictal period has not received as much attention as the time of seizure onset or the seizure itself. Here we review A long-standing bias suggests that temporal lobe epilepsy (TLE) is the epilepsy syndrome most often complicated by interictal (the time between seizures) cognitive and behavioral problems. A few do have episodes of aggressive behavior between seizures (interictal aggression). Seizures-related behavioral changes, including aggressive behaviors, have been interpreted as the emergence of “archeical” or innate motor patterns [17]. Mar 15, 2022 · The development of acute aggression requiring termination of Levetiracetam therapy has been rarely reported in the medical literature but poses a limiting effect on treatment options for refractory epilepsy in pediatric patients. [6] analyzed aggressive behavior captured by video surveillance of a total of 13 patients with epilepsy. Aggression more commonly takes place in the postictal state. It can also manifest as an episodic event independent of observable seizures, making it inter-ictal. Understanding Neurological Behavior Shifts Changes in behavior after a seizure are important to know. kgvaho rwulfiq zlosebsi jmf eswitj llsb xftkhy rugdz pnvr nhfv gtfoac egcr ohxt vyh wmyl