Ito Masumi, Okazaki Mitsutoshi, Takahashi Sho, Muramatsu Reimi, Kato Masaaki, Onuma Teiichi
Department of Psychiatry, National Center of Neurology and Psychiatry, Musashi Hospital, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8551, Japan.
Epilepsy Behav. 2007 Jun;10(4):611-4. doi: 10.1016/j.yebeh.2007.02.016. Epub 2007 Apr 5.
Three men with epilepsy (age range, 38-62) who exhibited brief episodes of violent behavior during the postictal period are described. Disease duration ranged from 27 to 44 years. Patients had both complex partial seizures and secondarily generalized tonic-clonic seizures, which were refractory to antiepileptic drugs. Postictal aggression occurred shortly after a seizure and lasted 5-30 minutes. The patients displayed physically and verbally aggressive behavior toward others, but regained consciousness promptly and showed regret afterward. Interictal EEGs revealed temporal spikes, SPECT showed hypoperfusion in the temporal and frontal areas in two patients, and neuropsychological examination revealed poor frontal lobe function in two patients. Characteristics of our cases are consistent with subacute postictal aggression (SPA) reported previously. Epilepsy of prolonged duration and brain dysfunction involving a broad area including the temporal and frontal lobes may be associated with the occurrence of subacute postictal aggression.
本文描述了三名癫痫患者（年龄范围为38 - 62岁），他们在发作后阶段出现了短暂的暴力行为发作。病程为27至44年。患者既有复杂部分性发作，也有继发性全身性强直阵挛发作，对抗癫痫药物难治。发作后攻击行为在癫痫发作后不久出现，持续5至30分钟。患者对他人表现出身体和言语上的攻击行为，但迅速恢复意识，事后表示后悔。发作间期脑电图显示颞叶尖波，两名患者的单光子发射计算机断层扫描（SPECT）显示颞叶和额叶灌注不足，两名患者的神经心理学检查显示额叶功能不佳。我们病例的特征与先前报道的亚急性发作后攻击行为（SPA）一致。病程较长的癫痫以及涉及包括颞叶和额叶在内的广泛区域的脑功能障碍可能与亚急性发作后攻击行为的发生有关。
