The Role of Culture in Temporal Lobe Epilepsy and Criminality: A Case Series from Malaysia

Abstract

Culture still plays an important role in the understanding of epilepsy among non-western developing nations. As a result, many patients are left undiagnosed and untreated until a serious incident such as an accident or a crime occurs, leading to medical attention. This case series gives two examples of patients who were sent for forensic psychiatric assessment after allegedly committing a crime in Malaysia. Both had temporal lobe epilepsy but diagnoses were delayed because of cultural beliefs, and ultimately they were acquitted using insanity as a defence. Implications from these cases include the need for improving public awareness of temporal lobe epilepsy as a treatable medical condition in view of the prevalent cultural belief of ‘possession states’, and the need for more streamlined and precise forensic services that would include an automatism defence.