Fact or fiction - the link between epilepsy and aggression
Tanis Rideout
Epilepsy and seizures have long been associated in our collective conscious with violence and aggression. It is seen in our movies and in our legal system. In 1873 British psychiatrist Henry Maudsley suggested that "whenever a murder occurs, without premeditation … we ought to look carefully for evidence of previous epilepsy."i In the film "Deceiver" a psychiatrist describes a person with epilepsy as "one of the most dangerous creatures on earth," and recommends that police officers treat him as you would treat a strange dog in an alley, "don't talk to him, don't look him in the eye, and whatever you do, don't touch him."ii Our own Canadian justice system heard testimony that a man who murdered his girlfriend in Timmins did so while "under the influence of an epileptic seizure".iii Is there any validity to these depictions? Can epilepsy be tied conclusively to directed violence?
Studies done in both Great Britain and the United States do, in fact, show a striking prevalence of epilepsy among prison populations. The statistical increase shown is approximately two to four times that of the general population. Furthermore, there was an even greater statistical increase among young offenders.iv So perhaps there is some link between epilepsy and aggressive violence.
These studies, however, showed no direct increase in the percentage of prisoners with epilepsy that had been convicted of serious or violent crimes. According to these studies there seemed to be no correlation between the type of crime and whether the convict had epilepsy or not, and no correlation between the type of crime and the type of epilepsy the prisoner has.v
Curious about the findings of these studies, an international workshop was convened and undertook the observation of aggression during epileptic seizures. They found that aggressive acts "appeared suddenly, without evidence of planning, lasted an average of 29 sec and occurred during partial complex seizures."vi They pointed out that the most important aspect to these acts is that there was clearly no forethought and that the aggressive action was extremely brief. Furthermore, the members of the workshop also determined that fear or an attempt at restraining the subject was also a factor in these aggressive acts. They determined, as a result of their observations, that it would be "a near impossibility"vii for a person having a seizure to commit a directed act of violence.
So why is there such a prevalence of people with epilepsy in prison? The answer may have more to do with sociological factors than with the actual physical action of seizures. As indicated by Epilepsy – a Comprehensive Textbook "additional psychological and social factors should be considered."viii These can be numerous in the case of people with epilepsy. Isolation, the stigmas surrounding the disorder, incorrect diagnosis and treatments can all add to feelings of unhappiness, and dissatisfaction that may manifest themselves in aggressive acts. Also, the distinct feelings of powerlessness and lack of control that having epilepsy brings may result in feelings of anger and aggression. As well, a large percentage of people with epilepsy tend to be economically disadvantaged as a result of numerous factors, including unfair workplace treatments, and government disability programs.ix The percentage of people in prisons that are economically disadvantaged vastly outweighs the percentage of people with epilepsy.
This should not, however, be used to dismiss the fact that some people with epilepsy do in fact become violent either during or after their seizures. There have been some findings that clearly indicate a connection between aggression and violence and "discharges in the amygdale and hippocampus."x These discharges, or irregular activity, however, can occur in people without epilepsy, due to brain trauma, or other physical or psychiatric disorders.
Clearly then, while there is a connection between activity in the brain, and aggression and violent acts, there is nothing inherent in people with epilepsy that can be connected to specific acts of violence. By acknowledging that some people with epilepsy may occasionally act out violently, either without being conscious of it during a partial seizure, if they are being restrained, or are frightened, or post-ictally out of a build up of frustration, of feeling that they are not in control of their own lives, we are acknowledging little more than that people act out aggressively in differing situations. Unfortunately, though, there is still a great deal of work to be done in shaking the popular point of view that people with the disorder tend to be unapproachable, aggressive and violent, and only through education and explanation can we change those opinions.
References:
i. Treiman, David M. "Epilepsy and Aggression"; Epilepsy: Current Approaches to Diagnosis and Treatment; David B. Smith ed.; Raven Press Ltd. New York; 1990
ii. Deceiver [Film]. Dir. Josh Pate and Jonas Pate. Metro Goldwyn Mayer, 1997
iii. Timmins Daily Press. Brazeau, David, "Court told Theberge 'confusional'" December 1995.
iv. Tremain, David M. "Epilepsy and Aggression"
v. Ibid.
vi. Engel, Jerome and Timothy A. Pedley Epilepsy- A Comprehensive Textbook Vol. 2; Lippencott-Raven 1997.
vii. Ibid.
viii. Ibid.
ix. Ibid.
x. Ibid.
