Behavior disorders related to epilepsy.

This chapter discusses episodic behavioral disorders that may be mistaken for seizures, but which are not caused by a primary disturbance of excitation and inhibition among neurons. Three major topics are discussed: hysterical or pseudoseizures, episodic aggression, and episodic psychosis. The development of techniques of simultaneously recording a video picture of behavior and the EEG has ushered in a new era in the analysis of patients with hysterical or pseudoseizures. Combined video/EEG monitoring is of proven effectiveness in making the distinction. Patients commonly suffer from both true and pseudoseizures, therefore it is often necessary for the patient to be seen in a special epilepsy center where anticonvulsants can be slowly withdrawn and both types of seizures documented. Detailed psychosocial evaluation is necessary to understand the behavior in the context of the patient's life. Intensive monitoring techniques have also been useful in dealing with the question of episodic behavioral disturbance. Episodic aggression is very difficult to study and the problem largely remains open.