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Ask the Mental Health Expert Archives 2001-2004

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Epilepsy And Sociopathic Behavior

Q. Is there a link between epilepsy and sociopathic behavior? If so how are they linked? Are there any scientific studies done on this topic?

A. I think we need to be careful here, in order to avoid stigmatizing a very large and diverse group of individuals, with various types of epilepsy. Overall, I'd say that there has been no clear, causal link established between epilepsy in general and sociopathic behavior (e.g., forging checks, stealing, assaulting people, showing flagrant disregard for the wellbeing of others, etc.)

However, depending on the type of epilepsy and the type of sociopathic behavior, there are some correlations that do appear frequently in the research literature. For example, one study (Fearnley D, Zaatar A.: Med Sci Law 2001 Oct;41(4):305-8) found that prisoners have a high prevalence of a family history of epilepsy. The study also showed that prisoners who report such a history have significantly more psychological symptoms than those prisoners without such a family history.

More directly, Pillman et al (J Neuropsychiatry Clin Neurosci 1999 Fall;11(4):454-7) studied the relationship of EEG abnormalities and violent criminal behavior in 222 defendants referred for psychiatric evaluation. There was no correlation between the number of violent offenses and EEG abnormalities in general. However, focal abnormalities, especially of the left hemisphere, were related to a significantly higher number of violent offenses.

In many cases these abnormalities were accompanied by mental retardation, epilepsy, or earlier brain damage. The authors concluded that "?impairment of left hemisphere functions may enhance the propensity for violent behavior in a subgroup of offenders." Another study by Woermann et al (J Neurol Neurosurg Psychiatry 2000 Feb;68(2):162-9) found that patients with temporal lobe epilepsy (TLE) and aggressive episodes had a decrease of grey matter, most markedly in the left frontal lobe, compared with the control group, and with TLE patients without aggressive episodes.

Since the frontal lobes help mediate appropriate social restraint, the authors concluded that, "?reduction of frontal neocortical grey matter might underly the pathophysiology of aggression in TLE..." All this said, I think it would be incorrect to infer that anybody with epilepsy is automatically predisposed to sociopathic behavior.

October 2003

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