[The behavioral disorders in epilepsy]

Abstract

The behavioral disorders are more frequent in the epilepsy patients, children and adults, than in the general population. They have been extensively studied by numerous authors, as well as the underlying various factors. These factors are neurobiological and psychological. From the neurobiological point of view, the importance of the brain damages, their nature, their topography, their lateralization, their date of occurrence during the development have been underlined. Specific personality and behavior features have been linked to the temporal localization of the epilepsy, but many controversies continue about this topic and a behavioral temporal syndrome is not proven. The frontal epilepsies are also responsible for psychological and behavioral disturbances. The epilepsy per se is an etiologic factor, through the ictal events and the interictal changes in the neuronal functioning. One example is that of the endogenous production of opioïd substances during the seizures. However the organic factors cannot be dissociated from the psychological ones. The neuropsychological deficits are significantly linked to the appearance of behavioral disorders in children. The stigma stuck to the epilepsy and the imprevisible character of the seizures have a deep resounding upon the subject, his family and his environment. The pharmacological medications are useful for the depressive and psychotic episodes, but have little efficacy on the character disorders, the aggressiveness and the psychogenic seizures. They need a careful assessment of the situation and a strict super vision of the seizure number (risk of worsening) and of the pharmacocinetic interactions. A comprehensive, social and psychological management of the epilepsy patients is always indicated, knowing that every person is unique and has to be understood and helped in his singularity.