▸ Can mimic focal seizures such as those arising from the temporal lobe

▸ The distinction is usually made by appreciating that PAs tend to be situational, and have a protracted course

▸ Violent uncontrollable aggression against an individual with or without provocation

▸ ‘Ictal aggression’ is rare, and is usually primitive, stereotyped and not directed against a certain person. It is commonly associated with other seizure types

▸ Depersonalisation (uncomfortable sense of unreality concerning one's self)

▸ Derealisation (uncomfortable sense of unreality concerning one's environment)

▸ May mimic epileptic aura

▸ Epileptic auras are usually short, and may be followed by ictal stereotyped motor behaviours

▸ These are usually complex as opposed to being elementary in focal seizures (eg, hearing voices of people vs hearing buzzing sounds)

▸ In epileptic seizures, there is an interval of normality

▸ The history can be suggestive, but not always

▸ Appropriate laboratory work up as indicated