The patient exhibiting episodic violent behavior.

This case presentation describes a 21-year-old white male patient seen for episodic violent behavior. The case is seen as relevant for primary care physicians because of the frequency of violent acting out in the general population, the importance of making an accurate diagnosis, and the many medical, psychological, and social implications involved in diagnosing such disorders. In such cases it is important that the physician keep an open mind and include within the differential diagnosis a variety of psychiatric disturbances such as paranoid schizophrenia, antisocial personality disorder, drug abuse syndromes including a variety of hallucinogens as well as prescription medication, organic diseases affecting the central nervous system, including encephalitis and temporal lobe epilepsy, and a variety of interpersonal difficulties, including spouse abuse and spousal rape. The case presentation method demonstrates how the psychiatric interview and a judicious use of biochemical and physiological testing can lead the practitioner to a correct diagnosis.