HOMICIDE, TEMPORAL LOBE EPILEPSY AND DEPRESSION: A CASE REPORT.

Abstract

It is well recognized that the depressed person occasionally commits murder as a consequence of the mood disorder (Mayer-Gross, Slater and Roth, 1960). Despite the popular view to the contrary, there is much evidence that murders are rarely committed in or after epileptic seizures. Alström (1950), in a study of the frequency of criminality in 345 adult male epileptics, did not find any cases of homicide. In a 10-year period, crimes of violence were recorded for 17 per cent of the patient series and 11 per cent. of a control group. All these crimes, however, were minor, usually a complication of the abuse of alcohol. Neither severe bodily injury to others, nor a crime committed during a psychomotor seizure were encountered. He also made the important observation that, while mentally normal patients with idiopathic epilepsy had an incidence of criminality similar to that of the general population, those epileptics displaying mental disorder in addition to fits had twice this frequency of criminal records. Hill and Pond (1952) state that, from their experience in an epilepsy ward and clinic, violent or dangerous behaviour during epileptic or post-epileptic automatisms is rarely seen in any patient. Levin (1952), who studied 52 cases of epileptic clouded state admitted to the Boston Psychopathic Hospital, concurs with this view. He comments that these patients are often potentially aggressive, but their intellectual faculties are so disorganized that they are unable to carry out well-planned integrated behaviour of any kind, including aggressive acts. However, in a clinical and EEG study of 100 prisoners awaiting trial for murder, Hill and Pond, in 1952, found 18 cases of epilepsy, an incidence of epilepsy thirty-two times that of the general population. In all these cases, careful examination of the circumstances of each crime excluded the occurrence of a seizure beforehand with a high degree of probability. They concluded that a relationship exists between epilepsy and murder, although it is not directly a result of the seizure or of its immediate sequelae. In some cases, at least, the common factor may be a mental illness in the epileptic, in which the epilepsy plays an important causative role. Pathogenic factors in such cases include the disturbance of cerebral function by the seizure discharges and also the difficulties in psychosocial adjustment caused by the fits themselves or the underlying organic brain disease causing them.