Forensic neuropsychiatric aspects of epilepsy

Epilepsy may be associated with automatisms that are classed as ‘insane ‘as they are deemed to have originated within the mind. ‘Sane automatism’ is said to occur from external factors, such as physical trauma, while ‘insane automatism’ is said to be innate to the individual experiencing them. To claim automatism within the context of a criminal matter requires a detailed evaluation of the behavior demonstrated and a questioning of the volitional and purposeful nature of this behavior. It is insufficient to rely upon past behavior in association with these seizures to justify the defense of automatism within a specific event. Epilepsy is often considered to be associated with an increase in violence. Proper epidemiological research, both in long-term, large population control studies and hospital-based studies, has suggested that epilepsy, per se, is not associated with an increase in violence when compared to the population at large and controlled for other familial and environmental factors.