Over 15 years, 2 of the researchers participated in the diagnostic evaluation of 197 juvenile and adult offenders. This study focuses on 30 of these offenders who had committed murder. Psychiatric and neurologic evaluations were conducted independently by two clinicians. The evaluations included detailed medical and family histories. Nineteen of the subjects had histories of severe head injuries, psychomotor symptomatology, psychotic symptoms, and a history of abuse or severe family violence. In four additional cases, the subjects had at least three of the above characteristics; in these cases, abuse or exposure to family violence were present. Only five subjects had two or fewer of the aforementioned characteristics. The episodic psychotic symptomatology of the subjects suggests that severe mental illness contributed to their violent behaviors. The syndrome of repeated violence by a subject with head injury, limbic dysfunction, episodic psychosis, and exposure to abuse or family violence does not fit into the DSM III psychiatric diagnostic categories or the neurologic diagnostic category of complex partial seizures or its synonyms. The identified syndrome might be termed a 'limbic-psychotic-aggressive syndrome.' 24 references and charts.