Gerard M E, Spitz M C, Towbin J A, Shantz D
Idaho State University, Pocatello, USA.
Neurology. 1998 Feb;50(2):384-8. doi: 10.1212/wnl.50.2.384.
To address clinical features of subacute postictal aggression, we examined aggressive behavior beginning hours to days after the acute confusional postictal period.
Six patients from our database of 1300 were assessed. Data was obtained from the patients, their family and caretakers, and medical records. One patient was studied with closed circuit video/EEG.
There is clinical heterogeneity among these individuals with respect to etiology of epilepsy, age of onset, laterality, memory of adverse behaviors, and presence of psychosis. Several clinical features, including male gender, were common to all. The episodes of postictal aggression were not isolated events, but recurred repeatedly; the behaviors were uniquely stereotyped in each patient. Subacute postictal aggression was more likely after a cluster of seizures than after a single ictus. All patients had medically intractable epilepsy and were remorseful in the interictal period.
Subacute postictal aggression, a rare phenomenon within the broad spectrum of epilepsy-related behaviors, appears to be a true clinical entity with several consistently observed manifestations.
为了研究亚急性发作后攻击行为的临床特征，我们对急性发作后意识模糊期数小时至数天开始的攻击行为进行了检查。
对我们1300例患者数据库中的6例患者进行了评估。数据来自患者、其家属和护理人员以及医疗记录。对1例患者进行了闭路电视/脑电图研究。
这些个体在癫痫病因、发病年龄、发作部位、不良行为记忆以及精神病存在方面存在临床异质性。包括男性在内的一些临床特征在所有患者中都很常见。发作后攻击事件并非孤立发生，而是反复出现；每个患者的行为都有独特的刻板模式。与单次发作相比，在一连串发作后更易出现亚急性发作后攻击行为。所有患者均患有药物难治性癫痫，且在发作间期感到懊悔。
亚急性发作后攻击行为是癫痫相关行为广泛范围内的一种罕见现象，似乎是一种具有几种一致观察到的表现的真实临床实体。
