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Case Study: Frontal Lobe Epilepsy and Links with Aggression

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Handbook of Anger, Aggression, and Violence

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Abstract

The study of epilepsy may provide remarkable insight in the neural mechanisms of aggressive behavior. 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. During focal seizures, the patient showed intense agitation and anger, for a long time misinterpreted as psychogenic attacks, which disappeared after epilepsy surgery. The defined anatomical origin of such ictal emotional behavior is not fully understood; however, the dorsal-lateral prefrontal area appears to correlate with aggressiveness, although less frequently compared to the antero-mesial and orbital prefrontal areas. We describe the electroclinical data of this patient and provide a brief review of the mechanisms underlying aggressive conduct in epilepsy. An understanding of these mechanisms may help to clarify the neural basis and treatment of aggressive behavior.

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Abbreviations

bvFTD:

behavior variant of frontotemporal dementia

FCD:

focal cortical dysplasia

GAM:

general aggression model

mPFC:

medial prefrontal cortex

PAG:

periaqueductal gray

PNES:

psychogenic non-epileptic seizures

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Author information

Authors and Affiliations

  1. Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy

    Roberta Di Giacomo

  2. Clinical Neurophysiology Unit and Epilepsy Center, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

    Flavio Villani

Authors
  1. Roberta Di Giacomo
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  2. Flavio Villani
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Corresponding author

Correspondence to Flavio Villani .

Editor information

Editors and Affiliations

  1. Institute for Health and Wellbeing, University of Suffolk, Ipswich, UK

    Colin R. Martin

  2. Faculty of Life Sciences and Medicine, King’s College London, London, UK

    Victor R. Preedy

  3. School of Life Sciences, University of Westminster, London, UK

    Vinood B. Patel

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Di Giacomo, R., Villani, F. (2023). Case Study: Frontal Lobe Epilepsy and Links with Aggression. In: Martin, C.R., Preedy, V.R., Patel, V.B. (eds) Handbook of Anger, Aggression, and Violence. Springer, Cham. https://doi.org/10.1007/978-3-031-31547-3_159

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