Download Arrest For Seizure-Related Behavior

Arrest For Seizure-Related Behavior
Seizures are caused by a sudden malfunction in the electrical system of the brain, which
has the effect of swamping part or all of the brain with an electrical overload. This in turn
produces temporary changes in behavior and/or consciousness. Seizures may be
convulsive or non-convulsive.
A non-convulsive seizure with automatic behavior is called a complex-partial seizure, or
a psychomotor or temporal lobe seizure. When a person has this type of seizure, s/he
appears to be in a dazed condition, may mumble or pick at clothing, may pick up an
object and put it down again, may walk aimlessly, or even run in apparent fear. During
these episodes the person is on "automatic pilot" so far as his or her actions are
concerned, is totally unaware of what is happening, and, when consciousness returns,
will have no memory of what occurred during the seizure. After a few minutes, natural
systems in the brain subdue the electrical overload which caused the seizure, and
consciousness returns. The person will become responsive, but may remain confused
for as much as half an hour to an hour.
A major problem in the public handling of psychomotor (complex partial) seizures is
recognition of the symptoms. The unusual behavior associated with complex partial
seizures is often misinterpreted as stemming from intoxication. A cardinal rule in the
handling of any seizure is that the person should not be restrained in any way unless it is
essential for his/her personal safety. The person in the midst of a complex partial seizure
may react violently to the restraint while unaware s/he is doing so. During the seizure the
person is in a confused mental state, but is usually amenable to suggestions and
comments made in a pleasant and friendly manner.
While in a semi-conscious or unconscious state, an individual with complex-partial
seizures may commit an undirected act which may be perceived as "criminal," e.g.,
shoplifting, disorderly conduct, etc., depending upon the characteristics of his seizure
disorder. Whether an individual's alleged criminal behavior was seizure-related is a
question that can best be answered by his or her neurologist. Witnesses' reports of
his/her exact behavior (as well as descriptions of his/her general behavior during a
seizure) will also be very helpful in determining whether s/he was in the midst of a
seizure. An expert familiar with the individual and his seizures will be crucial to defend
any criminal charges against him.
There have been many instances in which persons having seizures have been arrested
and charged with such crimes as drunk and disorderly conduct, resisting arrest, unlawful
entry, even assault on a police officer. The Epilepsy Foundation (EF) brought this
serious problem to the attention of the House of Representatives Judiciary Committee
during hearings on the Americans With Disabilities Act (ADA). In its final report, the
Committee stated:
In order to comply with the non-discrimination mandate, it is often necessary to provide
training to public employees about disability. For example, persons who have epilepsy,
and a variety of other disabilities, are frequently inappropriately arrested and jailed
because police officers have not received proper training in the recognition of and aid for
seizures. Often, after being arrested, they are deprived of medications while in jail,
resulting in further seizures. Such discriminatory treatment based on disability can be
avoided by proper training. Information obtained from the Epilepsy Foundation of
America website at www.efa.org.
Epilepsy and Violent Crime
The possible relationship between an epileptic seizure and criminal behavior beyond the
misdemeanor level is extremely controversial. It is generally agreed among neurologists
and epileptologists that well-organized, purposeful, complicated, or goal-directed
behavior is highly unlikely during a seizure. In order to evaluate the rare possibility that
an individual has committed a purposeful crime during a seizure, numerous variables
must be considered. These include whether the individual has epilepsy, the type of
seizure that person has, the type of behaviors he or she typically exhibits during a
seizure, the type of behavior the individual exhibits when not having seizures, and, the
most difficult to establish, a connection between the seizure disorder and its behavior
and the behavior taking place at the time of the crime. The opinion of the individual's
neurologist, who is familiar with his or her seizure pattern and behavior, will be very
important in making this determination.
A comprehensive article on the topic is Weinberg, C.D., "Epilepsy and the Alternatives
for a Criminal Defense," 27 Case W. L. Rev. 77l (l977). The following book contains
chapters on an alleged connection between various neurological disorders, including
epilepsy, and violent behaviors: Riley, T. and Roy, A., Pseudoseizures, Williams &
Wilkins, Baltimore (1982). Other articles that may be of interest include: Stevens, J. R. &
Hermann, B., "Temporal Lobe Epilepsy, Psychopathology and Violence: The State of the
Evidence, Neurology, Vol. 3l, pages ll27-ll32 (September l98l); Hermann, B., et al.,
"Interictal Psychopathology in Patients with Ictal Fear: A Quantitative Investigation,"
Neurology, Vol. 32, pages 7-ll (January l982); Letters to the Editor, Neurology, Vol. 32,
pages 574-575 (May l982); Treiman, D. & Delgado-Escueta, A., "Violence and Epilepsy A Critical Review," Recent Advances in Epilepsy, Churchill Livingstone (l983), and
Treiman, D.,"Epilepsy and Violence: Medical and Legal Issues," Epilepsia, Vol. 27
(Suppl. 2) S77-S104 (l986); Perlin, "Unpacking the Myths: The Symbolism Mythology of
Insanity Defense Jurisprudence," 40 Case Western L. Rev. 599 (1989-1990); Corrado,
"Automatism and the Theory of Action," 39 Emory L.J. 1191 (1990).
Following is a list of cases concerning epilepsy and criminal behavior. Most of these
cases involved violent acts. One case analyzing the issue is United States v. Voice, 627
F.2d l38 (8th Cir. l980). If it can be shown that a person was in the midst of a seizure (the
above criteria will be important), the defense of involuntariness, an "automatism," will be
available to negate intent. See also: State v. Massey, 747 P.2d 802 (Kan. 1987). A good
discussion of the automatism defense (and distinguishing this defense from an insanity
plea) can be found in People v. Grant, 360 N.E.2d 809 (l977), and State v. Caddell, 2l5
S.E.2d 348 (l975). See also: State v. Fields, 376 S.E.2d 740 (N.C. 1989). Cases in which
epilepsy has been used as the basis for an insanity defense include: Arizona v. Vickers,
768 P.2d 1177 (Ariz. 1989); Starr v. State, 2l3 S.E.2d 53l (Ga. App. l97l); Sprague v.
State, l87 N.W.2d 784 (Wis. l97l); People v. Codarre, 245 N.Y.S.2d 8l (App. Div. Sup. Ct.
N.Y. l963), aff'd, 200 N.E.2d 570 (l964), cert. denied, 379 U.S. 883; Brady v. State, l90
So.2d 607 (Fla. l966); and State v. Pettay, 532 P.2d l289 (Kan. l975); State v. Wimer,
284 S.E.2d 890 (W.Va. 1981); Davies v. State, 688 S.W.2d 738 (Ark. 1985); Frazier v.
State, 362 S.E.2d 351 (Ga. 1987) (Expert witness' testimony failed to establish that the
defendant's brain abnormality, which might diminish his impulse control and increase his
tendency to rage states, was related to his actions during the crime.)
While this material is designed to provide accurate and current information on the subject matter involved, the
Epilepsy Foundation and the authors cannot guarantee the accuracy or completeness of the information contained in
this publication. This fact sheet is not a legal document and does not provide legal advice or opinion. If legal advice or
other expert assistance is required, the services of a competent professional should be sought.
The most frequently asked questions about epilepsy
This page is intended to provide the basic information about epilepsy and seizure
disorders to the general public. It is not intended to, nor does it, constitute medical
advice, and readers are warned against changing medical schedules without first
consulting a physician.
What is epilepsy?
Epilepsy is a neurological condition that from time to time produces brief disturbances in
the normal electrical functions of the brain. Normal brain function is made possible by
millions of tiny electrical charges passing between nerve cells in the brain and to all parts
of the body. When someone has epilepsy, this normal pattern may be interrupted by
intermittent bursts of electrical energy that are much more intense than usual. They may
affect a person's consciousness, bodily movements or sensations for a short time.
These physical changes are called epileptic seizures. That is why epilepsy is sometimes
called a seizure disorder. The unusual bursts of energy may occur in just one area of the
brain (partial seizures), or may affect nerve cells throughout the brain (generalized
seizures). Normal brain function cannot return until the electrical bursts subside.
Conditions in the brain that produce these episodes may have been present since birth,
or they may develop later in life due to injury, infections, structural abnormalities in the
brain, exposure to toxic agents, or for reasons that are still not well understood. Many
illnesses or severe injuries can affect the brain enough to produce a single seizure.
When seizures continue to occur for unknown reasons or because of an underlying
problem that cannot be corrected, the condition is known as epilepsy. Epilepsy affects
people of all ages, all nations, and all races. Epilepsy can also occur in animals,
including dogs, cats, rabbits, and mice.
What is the difference between seizures and epilepsy?
Seizures are a symptom of epilepsy. Epilepsy is the underlying tendency of the brain to
produce sudden bursts of electrical energy that disrupt other brain functions. Having a
single seizure does not necessarily mean a person has epilepsy. High fever, severe
head injury, lack of oxygen--a number of factors can affect the brain enough to cause a
single seizure. Epilepsy, on the other hand, is an underlying condition (or permanent
brain injury) that affects the delicate systems which govern how electrical energy
behaves in the brain, making it susceptible to recurring seizures.
Which doctors treat epilepsy?
Neurologists, pediatric neurologists, pediatricians, neurosurgeons, internists and family
physicians all provide treatment for epilepsy. Specialized care for people whose seizures
are difficult to control is available in large medical centers, neurological clinics at
university and other hospitals, and from neurological specialists in private practice.
Is epilepsy ever contagious?
No, epilepsy is never contagious. You cannot catch epilepsy from someone else and
nobody can catch it from you.
What should I consider if there has been only a single seizure?
When a child or adult has never had a seizure before, the first seizure should be
followed by a careful medical evaluation to help the doctor decide whether to
recommend treatment with seizure-preventing drugs, or to wait and see whether it
occurs again. The most important factor in deciding whether to begin drug treatment for
a single seizure is the probability of further seizures. Physicians use both diagnostic
tests and careful evaluation of the seizure itself to determine how likely it is that the
patient may have more seizures in the future. Age, family history, and possible causes of
the seizure are among the factors that are considered. Non-medical issues, such as loss
of driver's license or worries about impact on employment, may also enter into the
decision.
What causes epilepsy?
In about seven out of ten people with epilepsy, no cause can be found. Among the rest,
the cause may be any one of a number of things that can make a difference in the way
the brain works. For example, head injuries or lack of oxygen during birth may damage
the delicate electrical system in the brain. Other causes include brain tumors, genetic
conditions (such as tuberous sclerosis), lead poisoning, problems in development of the
brain before birth, and infections like meningitis or encephalitis. Epilepsy is often thought
of as a condition of childhood, but it can develop at any time of life. About 30 percent of
the 125,000 new cases every year begin in childhood, particularly in early childhood and
around the time of adolescence. Another period of relatively high incidence is in people
over the age of 65.
What should I do if I suspect a seizure disorder?
If you think you or a loved one might be having seizures, it is important to discuss with
your physician what has been happening. Keep a record of how often the unusual
episode occurs, the time of day it happens and what form it takes. Giving the doctor this
information as it will help him or her to determine whether what you are describing might
be a type of epilepsy.
How is epilepsy diagnosed?
The doctor's main tool in diagnosing epilepsy is a careful medical history with as much
information as possible about what the seizures looked like and what happened just
before they began. A second major tool is an electroencephalograph (EEG). This is a
machine that records brain waves picked up by tiny wires taped to the head. Electrical
signals from brain cells are recorded as wavy lines by the machine. Brain waves during
or between seizures may show special patterns which help the doctor decide whether or
not someone has epilepsy. Imaging methods such as CT (computerized tomography) or
MRI (magnetic resonance imaging) scans may be used to search for any growths, scars,
or other physical conditions in the brain that may be causing the seizures. In a few
research centers, positron emission tomography (PET) imaging is used to identify areas
of the brain which are producing seizures.
How can people guard against having seizures?
A person with epilepsy can help control his or her seizures by taking the prescribed
medication regularly, maintaining regular sleep cycles, avoiding unusual stress, and
working closely with his or her physician. Regular medical evaluation and follow-up visits
are also important. However, seizures may occur even when someone is doing
everything he or she is supposed to.
How is epilepsy treated?
Epilepsy may be treated with drugs, surgery, or a special diet. Of these treatments, drug
therapy is by far the most common, and is usually the first to be tried. A number of
medications are currently used in the treatment of epilepsy. These medications control
different types of seizures. People who have more than one type of seizure may have to
take more than one kind of drug, although doctors try to control seizures with one drug if
possible. A seizure-preventing drug (also known as an antiepileptic or anticonvulsant
drug) won't work properly until it reaches a certain level in the body, and that level has to
be maintained. It is important to follow the doctor's instructions very carefully as to when
and how much medication should be taken. The goal is to keep the blood level high
enough to prevent seizures, but not so high that it causes excessive sleepiness or other
unpleasant side effects.