van der Feltz-Cornelis C. Treatment of interictal psychiatric disorder in epilepsy. III. Personality disorder, aggression and mental retardation.
Acta Neuropsychiatr 2002;
14:49-54. [PMID:
26983868 DOI:
10.1034/j.1601-5215.2002.140108.x]
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Abstract
BACKGROUND
Personality disorder, mental retardation and aggression are frequently encountered therapeutic problems in epilepsy patients.
OBJECTIVE
This paper gives an overview of symptomatology and treatment of personality disorder, interictal aggression and mental retardation in epilepsy.
METHODS
Literature review supplemented by clinical experience.
RESULTS
Personality changes in patients with epilepsy are often symptoms of an organic psychosyndrome. Aggression is not more frequent among epilepsy patients than in the general population, but if it does happen it is often more severe. There is a need for controlled treatment studies. A treatment strategy is suggested. In the mentally retarded, diagnostic instruments should be used to overcome diagnostic difficulties.
CONCLUSION
Prevalence studies based on DSM-IV personality disorder, conducted in the community, are needed, as well as systematic research on diagnosis and treatment of personality disorder in epilepsy patients. Randomized controlled trials (RCTs) considering the effectiveness and adverse effects of antidepressants and neuroleptics in epileptic patients with mental retardation are seriously needed. In the meantime, the Expert Consensus Guideline Series on Treatment of Psychiatric and Behavioural Problems in Mental Retardation is useful. The use of neuroleptics for the treatment of aggressive or destructive behaviour in nonpsychotic mentally retarded patients remains controversial.
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