Epilepsy and violence: case series concerning physical trauma in children of persons with epilepsy

Abstract

Historically, epilepsy has been associated with violence, but more recent studies have emphasized genetic and psychosocial factors as more important. The case series presented here aim to highlight the difficult situation the affected children are in. We report on three cases when children have been traumatized and, in one case, even been killed by their parent who was diagnosed with epilepsy. In the first case, we describe a woman with juvenile myoclonic epilepsy who was sentenced to forensic psychiatry care for killing her child. She lived under difficult psychosocial circumstances and a suicide attempt contributed to what happened. The second case describes a man with post-traumatic seizures who was sentenced for child abuse. Ictal or postictal violence was considered in these two cases but a causal link between the violence and epilepsy has not been established. In the third case, we describe a woman with focal epilepsy and psychogenic non-epileptic seizures (PNESs). Her child was hurt and frightened in relation to violent seizures, which were regarded as PNESs. This case series demonstrates that children of parents with epilepsy can be in a vulnerable situation. No causality has been established between the seizures and these events, so consequently other factors such as psychosocial stress, low cognitive function, and a suicide attempt must also be considered as important. When a child is hurt by a parent with epilepsy the patient must be closely examined to determine the role of the seizures. Children can also be affected by PNESs. It is essential to notice especially those children of parents with epilepsy who live under difficult psychosocial circumstances and offer extra support when necessary.

Experimental Imaging Study of Encephalomalacia Fluid-Attenuated Inversion Recovery (FLAIR) Hyperintense Lesions in Posttraumatic Epilepsy

“…Many studies have shown that local mossy fiber sprouted around brain contusion lesions. Mossy fiber germination is associated with increased epileptic activity after brain trauma, suggesting that mossy fiber germination may be related to the occurrence of epilepsy [ 19 , 20 ]. And these are some studies about NODDI findings in epilepsy.…”

Epilepsy, violence, and crime. A historical analysis

“…One of the most apparent conclusions to be drawn from the history of epilepsy is that the popular 19th‐century idea according to which there is a link between epilepsy and certain psychological features has lingered on, and some of the seemingly outdated, highly problematic theories concerning the behavioral aspects of epilepsy have continued to survive. Whether hidden or openly professed, these theories are not only alive, but also influence research questions, theories, and even psychiatric, psychological practice (see e.g., Aycicegi‐Dinn et al, 2008; Bear & Fedio, 1977; Delgado‐Escueta et al, 1981, 2002; Every‐Palmer & Norris, 2013; Freud, 1961; Gauffin & Landtblom, 2014; Geschwind, 2009; Granieri & Fazio, 2012; Kim et al, 2011; Musumeci, 2013; Persinger et al, 2010; Reuber & Mackay, 2008; Riley & Niedermeyer, 1978; Saleh et al, 2019; Yankovsky et al, 2005). The origins of these lingering ideas on epilepsy can be traced to the lengthy debate regarding the so‐called epileptic character or personality .…”

‘They accused me of strangling her’: epilepsy and violence debate in Croatia at the end of the nineteenth and the beginning of the twentieth centuries

“…While statistical data on the connection between violence and epilepsy have improved our understanding and dispelled many myths, they are of limited value in assessing individual cases of epileptic violence. Persons with epilepsy who have committed violent acts have received widely different treatment, with forensic experts still crucial in shaping their destiny (Gauffin and Landtblom, 2014; Reuber and Mackay, 2008). This shows not only that the court verdict ultimately depends on professional forensic expertise, but also that there is still no agreement within the medical and legal communities about the exact role of epilepsy in violent episodes.…”