Department of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Neuropsychiatr Dis Treat. 2013;9:667-73. doi: 10.2147/NDT.S45370. Epub 2013 May 14.
We report the rare case of a patient with intractable epilepsy and escalating aggression, resulting in murder, who had complete resolution of her seizures and explosive behavior following a right temporal lobectomy.
We searched the available literature from 1880 to 2013 for cases of epilepsy being used as a court defense for murder and collected information regarding the final sentencing outcomes. We selected 15 papers with a total of 50 homicides.
We describe the case of a 47-year-old woman with drug-resistant right temporal epilepsy who developed increasing emotional lability, outbursts of anger and escalating violent behavior culminating in a violent murder. The patient was imprisoned while awaiting trial. In the interim, she underwent a successful temporal lobectomy with full resolution of seizures, interictal rage and aggressive behaviors. After the surgery, her charges were downgraded and she was transferred to a psychiatric facility.
The aggressive behavior associated with epilepsy has been described in the literature for over a century. A link between epilepsy and aggression has been disproportionally emphasized. These patients share some common characteristics: they are usually young men with a long history of epilepsy and lower than average intelligence. The violent act is postictal, sudden-onset, more likely to occur after a cluster of seizures and is usually related with alcohol abuse.
我们报告了一例罕见的难治性癫痫伴进行性加重的攻击性病例，该患者在接受右侧颞叶切除术治疗后，癫痫完全缓解，且爆发性行为得到控制。
我们从 1880 年至 2013 年搜索了可用于癫痫作为谋杀罪辩护的可用文献，并收集了有关最终判决结果的信息。我们选择了 15 篇论文，共涉及 50 起凶杀案。
我们描述了一例 47 岁女性的病例，她患有耐药性右侧颞叶癫痫，出现情绪不稳、愤怒爆发和暴力行为逐渐升级，最终导致暴力杀人。患者在等待审判期间被监禁。在此期间，她接受了成功的颞叶切除术，癫痫、发作间期愤怒和攻击性行为完全缓解。手术后，她的指控被降级，她被转移到一家精神病院。
癫痫相关的攻击性行为在文献中已经描述了一个多世纪。癫痫与攻击性之间的联系被不成比例地强调。这些患者有一些共同特征：他们通常是年轻男性，癫痫病史长，智力低于平均水平。暴力行为是癫痫发作后出现的，突然发生，更可能在一连串癫痫发作后发生，通常与酒精滥用有关。
