Episodic dyscontrol syndrome

Episodic dyscontrol syndrome (EDS, or sometimes just "dyscontrol"), is a pattern of abnormal, episodic, and frequently violent and uncontrollable social behavior [Elliott FA. (1984) The episodic dyscontrol syndrome and aggression. Neurologic Clinics 2: 113–25.] in the absence of significant provocation [Maletzky BM. (1973) The episodic dyscontrol syndrome. Disorders of the Nervous System 34: 178–85.] ; it can result from limbic system diseases, disorders of the temporal lobe, [cite journal
last = Tebartz van Elst
first = Dr. L.
coauthors = F. G. Woermann, L. Lemieux, P. J. Thompson and M. R. Trimble
year = 2000
month = February
title = Affective aggression in patients with temporal lobe epilepsy "A quantitative MRI study of the amygdala"
journal = Brain
volume = 123
issue = 2
pages = 234–243
publisher = Oxford University Press
location = Oxford UK
issn = 0006-8950
doi = 10.1093/brain/123.2.234] or abuse of alcohol or other psychoactive substances. [Drake ME, Hietter SA, Pakalnis A. (1992) EEG and evoked potentials in episodic-dyscontrol syndrome. Neuropsychobiology 26: 125–8.] [Harbin HT. (1977) Episodic dyscontrol and family dynamics. American Journal of Psychiatry 134: 1113–6.]

EDS may affect children or adults. [Nunn K. (1986) The episodic dyscontrol syndrome in childhood. Journal of Child Psychology and Psychiatry 27: 439–46.] [Bach-y-Rita G, Lion JR, Climent CE, Ervin FR. (1971) Episodic (1986) dyscontrol: a study of 130 violent patients. American Journal of Psychiatry 127: 49–54.] [Elliott FA. (1982) Neurological findings in adult minimal brain dysfunction and the dyscontrol syndrome. Journal of Nervous and Mental Disease 170: 680–7.]

Treatment

Treatment for EDS usually involves treating the underlying causative factor(s). This may involve psychotherapy, substance abuse treatment, or medical treatment for diseases.

EDS has been successfully controlled in clinical trials using prescribed medications, including Carbamazepine [Tunks ER, Dermer SW. (1977) Carbamazepine in the dyscontrol syndrome associated with limbic system dysfunction. Journal of Nervous and Mental Disease 164: 56–63.] [Lewin J, Sumners D. (1992) Successful treatment of episodic dyscontrol with carbamazepine. British Journal of Psychiatry 161: 261–2.] , Ethosuximide [Andrulonis PA, Donnelly J, Glueck BC, Stroebel CF, Szarek BL. (1990) Preliminary data on ethosuximide and the episodic dyscontrol syndrome. American Journal of Psychiatry 137: 1455–6.] , and Propranolol [Grizenko N, Vida S. (1988) Propranolol treatment of episodic dyscontrol and aggressive behaviour in children. Canadian Journal of Psychiatry 33: 776–8.] .

Legal implications

A diagnosis of EDS has been used as a defense in court for persons accused of committing violent crimes including murder. [Myers WC, Vondruska MA. (1998) Murder, minors, selective serotonin reuptake inhibitors, and the involuntary intoxication defence. Journal of the American Academy of Psychiatry and Law 26: 487–96.] [cite book
last = Simon
first = Robert I.
title = Review of Clinical Psychiatry and the Law
format = Hardback
edition = Version 2
date = 1990-12-01
publisher = American Psychiatric Pub, Inc.
location = Arlington
isbn = 0880483768
pages = 424
chapter = A Canadian Perspective (p. 392)
quote = The decision in a case concerning episodic dyscontrol syndrome seems to have expanded the definition of "diseases of the mind". In R. v. Butler, the accused had a history of injuries to the head. He was charged with aggravated assault of his wife's infant son. The child had been badly beaten on the head, and the accused, while admitting that he was alone at home with the child, had no memory of beating the child on the head. The medical history of the accused was brought forward at the trial, and a neurologist ventured the opinion that he sufferred from episodic dyscontrol syndrome, entailing an interruption of normal control mechanisms. His other violent acts were symptomatic. In the court decision, it was noted that disease of the mind had both a legal and medical component.] [cite book
last = Tiffany
first = Lawrence P.
coauthors = Tiffany, Mary
title = The Legal Defense of Pathological Intoxication "With Related Issues of Temporary and Self-Inflicted Insanity"
format = Hardcover
date = 1990-09-11
publisher = Quorum Books
location = New York
isbn = 0-89930-548-2
oclc =
doi = 10.1336/0899305482
id =
pages = 560
chapter = 5]

See also

* Intermittent explosive disorder

References

External links

* [http://www.mercksource.com/pp/us/cns/cns_hl_dorlands.jspzQzpgzEzzSzppdocszSzuszSzcommonzSzdorlandszSzdorlandzSzdmd_s_32zPzhtm#12779514 Dorland's Medical Dictionary]