EPILEPSY AND BEHAVIOR

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Abstract
BACKGROUND The relationship between epilepsy and behavior is one of the most controversial areas of study in neurology. The clinician is faced with a bewildering array of studies that present dogmatic and yet often contradictory points of view. REVIEW SUMMARY This review presents a practical approach to the literature of psychiatric and psychosocial issues in epilepsy, highlighting the strengths as well as the methodologic difficulties of key studies. The first section summarizes current understanding of the complex relationship of epilepsy with global psychopathology, the temporal lobe personality syndrome, psychosis, depression, anxiety, and aggressive behavior. The effect of behaviors on seizures and the topic of nonepileptic seizures are also highlighted. The second section discusses important issues involved in pharmacologic therapies, including potential adverse behavioral effects of antiepileptic drugs, the risks of lowering seizure threshold with the use of psychotropic drugs, and common drug interactions between anticonvulsants and psychotropic agents. We conclude with a discussion of quality of life in epilepsy. CONCLUSION Careful analysis of the complex literature of psychiatric issues in epilepsy provides practical and useful clinical guidelines for diagnosis and management. OVERVIEW Few subjects in neuropsychiatry have generated as much interest and controversy as the relationship of psychopathology to epilepsy. This review is designed to be a source of practical clinical information useful in the diagnosis and management of psychopathology in epilepsy. It is also a guided tour through a very complicated literature; we note salient studies that have advanced our understanding of this topic, as well as methodological difficulties that leave many questions unresolved.

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