The Demographic, Clinical and Forensic Profile of Offenders Diagnosed with Epilepsy Referred to the Free State Psychiatric Complex Observation Unit in Terms of Section 77 and/Or 78 of the Criminal Procedure Act 51 of 1977‪.‬

Although violent behaviour may be associated with ictal, postictal and interictal phases (1-4) of epilepsy, accounts of criminal behaviour directly linked to epilepsy remain rare and unconvincing. (5) Modern studies generally fail to demonstrate an increased tendency towards violent behaviour in people with epilepsy. (6) However, several epidemiological studies reveal an increased occurrence of violence among those with seizures compared with those without seizures. Research and clinical observations suggest that violence tends to occur more often during seizure-free periods, and that various factors contribute to aggressive behaviour associated with epilepsy. (6) These are very complex and range from sociological to psychological and biological factors. Low socio-economic status, psychosocial consequences of epilepsy and the strong association between poor impulse control and structural brain pathology have all been linked to violence and epilepsy. (4,7) Mendez et al. (6) reported that violence associated with epilepsy usually results from associated factors such as poor impulse control, cognitive impairment, or other psychopathology. While some authors such as Livingston8 view the relationship between epilepsy and violence as purely incidental, several other researchers have demonstrated an association. (1,2,9-13) Many of the studies in this field, however, are methodologically flawed and fail to control for factors such as socio-economic status and the role of physical trauma. Whitman et al. (14) concluded in their methodologically sound study that an intrinsic biological relationship between epilepsy and aggressiveness is unlikely. Their findings rather suggest a relationship between low socioeconomic status, epilepsy and violence. (14)