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June 1982

Epilepsy and Episodic Aggression-Reply

Author Affiliations

Department of Neurology Mayo Box 374 University of Minnesota Hospitals 420 SE Delaware St Minneapolis, MN 55455

Arch Neurol. 1982;39(6):385-386. doi:10.1001/archneur.1982.00510180063023

In Reply.—  We appreciate Dr Mark's comments. The subject of aggression in epilepsy has recently generated a good deal of controversy and debate.1-3 The issue is complex and involves at least five specific questions of fundamental importance: (1) What is the prevalence of aggression among epileptics, and are epileptics more aggressive than nonepileptics? (2) Is aggressive behavior unique to limbic or TLE? (3) Are the aggressive episodes in epileptics ictal or interictal? (4) If interictal, what is the nature of the interaction between the neural dysfunction and the environment? (5) Can ictal aggression lead to acts of violence? These are five separate issues, and this distinction must be kept in clear focus at all times. Failure to do so can only lead to further confusion and controversy. Unfortunately, this seems to be the case with Dr Mark's response to our study (Archives 1981;38:570-571). This has rendered his otherwise thoughtful criticisms not