Behavior disorders occur in 28.6% of children with uncomplicated seizures and in 58.3% of children with seizures and other brain dysfunctions, according to parent and teacher reports (Dunn & Austin, 1998). Children struggling with the problem of epilepsy often display acting-out behaviors. They may seem moody or they may display erratic, variable, unpredictable behaviors. Some children seem irritable, exhibiting angry outbursts of temper. Their attention spans may seem shortened. Some children are anxious and jittery, with hyperactive behavior.

Rebellious, resentful attitude

The child, especially in adolescence, may try to escape from the parents' overly restrictive demands through rebellion. Some children may be so discouraged that they lash out angrily. Some may try to blame others for rejecting them because of the seizures. They seem angry, hostile, and aggressive. The school record may be one of absenteeism. Some may develop frank antisocial and delinquent behavior. Such children need intensive guidance and counseling so that they may finally accept the epilepsy and develop a better self-concept and therefore move ahead.

Impulse-control problems

Over the years, impulse-control problems have emerged with a variety of names, including episodic dyscontrol syndrome, intermittent explosive disorder, and “rage” reactions. Impulse-control problems may be seen in personality disorders, with cerebral damage as with seizure activity, structural loss, antiepileptic drugs, and social deprivation.

The possibility of an ictal basis for aggressive symptoms as part of the interictal period, in which aggressive behavior may follow one or more serial unrecognized seizures, is debated.