Epilepsy and criminal behavior (review of literature)
https://doi.org/10.31363/2313-7053-2025-1-934
Abstract
With epilepsy, behavioral disorders are possible, including criminal ones. Criminal incidents can occur in the preictal, interictal, ictal and postictal periods, and may be due to adverse events of anticonvulsants and other factors. The most dangerous postictal behavioral disorder, including in terms of criminal incidents, is postictal psychosis.
Often people with epilepsy need experienced neurologists and lawyers to resolve criminal situations. The International League Against Epilepsy recommends criteria for determining whether a particular criminal act committed by a patient with epilepsy is the result of an epileptic seizure.
In general, a forensically sound, comprehensive interdisciplinary approach to the diagnosis of criminal behavior in epilepsy is required, which combines neuropsychiatric, neuropsychological and psychophysiological methods, taking into account risk factors and aggravating factors.
About the Authors
G. M. MusinaRussian Federation
Gulisa M. Musina
Voronezh
K. V. Voronkova
Russian Federation
Kira V. Voronkova
Moscow
A. S. Petrukhin
Russian Federation
Andrey S. Petrukhin
Moscow
References
1. Abrantes JS, Lobarinhas MJ, Lourenço JP. A Case of Postictal Psychosis. Prim Care Companion CNS Disord. 2023;25(4):22cr03439. https://doi.org/10.4088/PCC.22cr03439.
2. Agrawal N, Mula M. Treatment of psychoses in patients with epilepsy: an update. Ther Adv Psychopharmacol. 2019;9:2045125319862968. https://doi.org/10.1177/2045125319862968
3. Barrett K. The first appearance of EEG evidence in a UK court of law: a cautionary tale. BJPsych Bulletin. 2024;48(2):124-126. https://doi.org/10.1192/bjb.2022.88
4. Beniczky S, Tatum WO, Blumenfeld H, Stefan H, Mani J, Maillard L, Fahoum F, Vinayan KP, Mayor LC, Vlachou M, Margitta S, Ryvlin Ph, Philippe K. Seizure semiology: ILAE glossary of terms and theirsignificance. Epileptic Disord. 2022;24(3):447-495. https://doi.org/10.1684/epd.2022.1430
5. Braatz V, Custodio HM, Leu C, Agrò L, Wang B, Calafato S, Doyle MG, Hengsbach Ch, Bisulli F, Weber YG, Gambardella A, Delanty N, Cavalleri G, Foong J, Scheffer IE, Berkovic SF, Bramon E, Balestrini S, Sisodiya SM. Postictal Psychosis in Epilepsy: A Clinicogenetic Study. Ann Neurol. 2021;90(3):464-476. https://doi.org/10.1002/ana.26174.
6. Brodie MJ, Besag F, Ettinger AB, Mula M, Gobbi G, Comai S, Aldenkamp AP, Steinhoff B. Epilepsy, Antiepileptic Drugs, and Aggression: An Evidence-Based ReviewAn external file that holds a picture, illustration, etc. J. Pharmacol Rev. 2016;68(3):563–602. https://doi.org/10.1124/pr.115.012021 /
7. Buranee K, Teeradej S, Chusak L, Michael M. Epilepsy-related psychoses and psychotic symptoms are significantly reduced by resective epilepsy surgery and are not associated with surgery outcome or epilepsy characteristics: A cohort study. Psychiatry Res. 2016;245:333-339. https://doi.org/10.1016/j.psychres.2016.08.020
8. Casula А, Milazzo BM, Martino G, Sergi A, Lucifora Ch, Tomaiuolo F, Quartarone A, Nitsche MA, Vicario CM. Non-Invasive Brain Stimulation for the Modulation of Aggressive Behavior-A Systematic Review of Randomized Sham-Controlled Studies. . 2023;13(5):1220. https://doi.org/10.3390/life13051220
9. Chbeir S, Carrión V. Resilience by design: How nature, nurture, environment, and microbiome mitigate stress and allostatic load World J Psychiatry. 2023;13(5):144–159. https://doi.org/10.5498/wjp.v13.i5.144
10. Chen Z, Lusicic A, O’Brien TJ, Velakoulis D, Adams SJ, Kwan P. Psychotic disorders induced by antiepileptic drugs in people with epilepsy 2016;139(Pt 10):2668-2678. https://doi.org/10.1093/brain/aww196.
11. Christensen J, Dreier JW, Sun Y, Linehan C, Tomson T, Marson A, Forsgren L, Granbichler CA, Trinka E, Illiescu C, Malmgren K, Kjellberg J, Ibsen R, Jennum PJ. ESBACE Consortium and ESBACE Collaborators. Estimates of epilepsy prevalence, psychiatric co-morbidity and cost. Seizure. 2023;107:162-171. https://doi.org/10.1016/j.seizure.2022.06.010.
12. Cohen Kadosh K, Muhardi L, Parikh P, Basso M, Jan Mohamed HJ, Prawitasari T, Samuel F, Ma G, Geurts JM. Nutritional Support of Neurodevelopment and Cognitive Function in Infants and Young Children-An Update and Novel Insights. Nutrients. 2021;13(1):199. https://doi.org/10.3390/nu13010199.
13. Dang H, Khan AB, Gadgil N, Sharma H, Trandafir С, Malbari F, Weiner HL. Behavioral Improvements following Lesion Resection for Pediatric Epilepsy: Pediatric Psychosurgery PediatrNeurosurg. 2023;58(2):80-88. https://doi.org/10.1159/000529683.
14. Darby RR, Considine C, Weinstock R, Darby WC. Forensic neurology: a distinct subspecialty at the intersection of neurology, neuroscience and law. Nat Rev Neurol. 2024;20(3):183-193. https://doi.org/10.1038/s41582-023-00920-0
15. Denton A, Tellez-Zenteno JF. A patient with epilepsy charged with kidnapping, unlawful confinement, and assault causing bodily harm after seizures: Deficiencies in the legal system. Epilepsy Behav Rep. 2020;13:100361. https://doi.org/10.1016/j.ebr.2020.100361
16. Dunkel H, Strzelczyk A, Schubert-Bast S, Kieslich M. Facial Emotion Recognition in Patients with Juvenile Myoclonic Epilepsy. J Clin Med. 2023;12(12):4101. https://doi.org/10.3390/jcm12124101
17. EPIGRAPH VOL. 22 ISSUE 2, SPRING 2020. After the wave subsides: Post-ictal effects. [ilae.org]. Ilae; 2020. Available: https://www.ilae.org/journals/epigraph/epigraph-vol-22-issue-2-spring-2020/after-thewave-subsides-post-ictal-effects
18. EPIGRAPH VOL. 22 ISSUE 2, SPRING 2020. Post-ictal psychosis: Identification, treatment and prevention. [ilae.org]. Ilae; 2020. Available: https://www.ilae.org/journals/epigraph/epigraph-vol-22-issue-2-spring-2020/post-ictal-psychosis-identification-treatment-and-prevention
19. Evers MEA, Nelissen J, Vlooswijk MCG, van Kranen-Mastenbroek VHBM, Leentjens AFG, Rouhl RPW; AWEC-study group. Risk factors for behavioral and psychotic dysregulation at the epilepsy monitoring unit in patients with intracranial electrodes. Epilepsy Behav. 2023;148:109448. https://doi.org/10.1016/j.yebeh.2023.109448.
20. Fernàndez-Castillo N, Cormand B. Aggressive behavior in humans: Genes and pathways identified through association studies. Am J Med Genet B Neuropsychiatr Genet. 2016;171(5):676-696. https://doi.org/10.1002/ajmg.b.32419
21. Gibbs FA, Davis H, Lennox WG. The electro-encephalogram in epilepsy and in conditions of impaired consciousness. Archives of Neurology & Psychiatry, 1935;34(6):1133–1148. https://doi.org/10.1001/archneurpsyc.1935.02250240002001
22. Grigoletti-Lima GB, Lopes MG, Barufi Franco AT, Damico AM, Boer PA and Rocha Gontijo JA. Severe Gestational Low-Protein Intake Impacts Hippocampal Cellularity, Tau, and Amyloid-β Levels, and Memory Performance in Male Adult Offspring: An Alzheimer-Simile Disease Model. J Alzheimers Dis Rep. 2022;6(1):17–30. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8842744/
23. Gyimesi J. Epilepsy, violence, and crime. A historical analysis. J HistBehavSci. 2022;58(1):42-58. https://doi.org/10.1002/jhbs.22117.
24. Harper KM, Harp SJ, Moy SS. Prenatal stress unmasks behavioral phenotypes in genetic mouse models of neurodevelopmental disorders. Front Behav Neurosci. 2023;17:1271225. https://doi.org/10.3389/fnbeh.2023.1271225
25. Hedaya A, Ver Hoef L. «Amity Seizures»: A previously unreported semiology localizing to a circuit between the right hippocampus and orbitofrontal area. Epilepsy Behav Rep. 2024;25:100649. https://doi.org/10.1016/j.ebr.2024.100649
26. Hungwe MM, Lowton K. Assessing the prevalence of psychotic symptoms in epileptic patients at a tertiary clinic. S Afr J Psychiatr. 2023;29:2062. https://doi.org/10.4102/sajpsychiatry.v29i0.2062
27. Kalscheuer VM, Musante L, Fang C, Hoffmann K, Fuchs C, Carta E, Deas E, Venkateswarlu K, Menzel C, Ullmann R, Tommerup N, Dalprà L, Tzschach A, Selicorni A, Lüscher B, Ropers HH, Harvey K, Harvey RJ. A balanced chromosomal translocation disrupting ARHGEF9 is associated with epilepsy, anxiety, aggression, and mental retardation. Hum Mutat. 2009;30(1):61-8. https://doi.org/10.1002/humu.20814.
28. Kanemoto K, Tadokoro Y, Oshima T. Violence and postictal psychosis: a comparison of postictal psychosis, interictal psychosis, and postictal confusion. Epilepsy Behav. 2010;19(2):162-6. https://doi.org/10.1016/j.yebeh.2010.06.018.
29. Kawai M, Goji H, Kanemoto K. Aggression as psychiatric side effect of newer AEDs in patients with epilepsy: Cross-sectional study based on Buss-Perry Aggression Questionnaire. Epilepsy Behav. 2021;115:107546. https://doi.org/10.1016/j.yebeh.2020.107546
30. Kempes M. Added value of neurotechnology for forensic psychiatric and psychological assessment. Handb Clin Neurol. 2023;197:217-232. https://doi.org/10.1016/B978-0-12-821375-9.00015-3
31. Kessi M, Duan H, Xiong J, Chen B, He F, Yang L, Ma Y, Bamgbade OA, Peng J, Yin F. Attention-deficit/hyperactive disorder updates. Front MolNeurosci. 2022;15:925049. https://doi.org/10.3389/fnmol.2022.
32. Kim JM, Chu K, Jung KH, Lee ST, Choi SS, Lee SK. Characteristics of Epilepsy Patients who Committed Violent Crimes: Report from the National Forensic Hospital. J Epilepsy Res. 2011;1(1):13-8. https://doi.org/10.14581/jer.11003.
33. Konicar L, Radev S, Silvoni S, Bolinger E, Veit R, Strehl U, Vesely C, Plener PL, Poustka L, Birbaumer N. Balancing the brain of offenders with psychopathy? Resting state EEG and electrodermal activity after a pilot study of brain self-regulation training. PLoS One. 2021;16(1):e0242830. https://doi.org/10.1371/journal.pone.0242830.
34. Korner M, Kälin S, Zweifel-Zehnder A, Fankhauser N, Nuoffer JM, Gautschi M. Deficits of facial emotion recognition and visual information processing in adult patients with classical galactosemia. Orphanet J Rare Dis. 2019;14(1):56.https://doi.org/10.1186/s13023-019-0999-3
35. Leroy F, Park J, Asok A, Brann DH, Meira T, Boyle LM, Buss EW, Kandel ER, Siegelbaum SA. A circuit from hippocampal CA2 to lateral septum disinhibits social aggression. Nature. 2018;564 (7735):213-218. https://doi.org/10.1038/s41586-018-0772-0.
36. Ling S, Umbach R, Raine A. Biological explana- tions of criminal behavior. Psychol Crime Law. 2019;25(6):626-640. https://doi.org/10.1080/1068316X.2019.1572753.
37. Maresca G, Lo Buono V, Anselmo A, Cardile D, Formica C, Latella D, Quartarone A, Corallo F. Traumatic Brain Injury and Related Antisocial Behavioral Outcomes: A Systematic Review. Medicina (Kaunas). 2023;59(8):1377. https://doi.org/10.3390/medicina59081377
38. McSherry B, Cook M. Seizures, Postictal States and Criminal Responsibility. J Law Med. 2022;29(3):707-713
39. Monaco F, Mula M. Cesare Lombroso and epilepsy 100 years later: an unabridged report of his original transactions. Epilepsia. 2011;52(4):679-688. https://doi.org/10.1111/j.1528-1167.2010.02959.x
40. Moog NK, Entringer S, Heim C, Wadhwa PD, Kathmann N, Buss C. Influence of maternal thyroid hormones during gestation on fetal brain development. Neuroscience. 2017;342:68–100. https://doi.org/10.1016/j.neuroscience.2015.09.070
41. Moreno-Ibáñez MÁ, Linda F, Palmira S. Unraveling Neolithic sharp-blunt cranial trauma: Experimental approach through synthetic analogues. Journal of Archaeological Science. 2023;151:105739. https://doi.org/10.1016/j.jas.2023.105739
42. Pandya NS, Vrbancic M, Ladino D, Téllez-Zenteno JF. Epilepsy and homicide Neuropsychiatr Dis Treat. 2013:9:667-73. https://doi.org/10.2147/NDT.S45370.
43. Peng Sh-X, Pei J, Rinaldi B, Chen J, Ge Y-H, Jia M, Wang J, Delahaye-Duriez A, Sun J-H, Zang Y-Y, Shi Y-Y, Zhang N, Gao X, Milani D, Xu X, Sheng N, Gerard B, Zhang Ch, Bayat A, Liu N, Yang J-J, Shi YS. Dysfunction of AMPA receptor GluA3 is associated with aggressive behavior in human. Mol Psychiatry. 2022;27(10):4092-4102. https://doi.org/10.1038/s41380-022-01659-8.
44. Regala J, Lourenço J, Moniz-Pereira F, Bento A. Postictal Psychosis: Case Report and Literature Review. Case Rep Psychiatry. 2023:7960227. https://doi.org/10.1155/2023/7960227
45. Reuber M, Mackay RD. Epilepsia. Epileptic automatisms in the criminal courts: 13 cases tried in England and Wales between 1975 and 2001. 2008;49(1):138-45. https://doi.org/10.1111/j.1528-1167.2007.01269.x
46. Saleh Ch, Reuber M, Beyenburg S. Epileptic seizures and criminal acts: Is there a relationship? Epilepsy Behav. 2019:97:15-21. https://doi.org/10.1016/j.yebeh.2019.05.015. Epub 2019 Jun 7.
47. Schirmann F. «The wondrous eyes of a new tech- nology»-a history of the early electroencephalogra- phy (EEG) of psychopathy, delinquency, and immo- rality. Front Hum Neurosci. 2014;8:232. https://doi.org/10.3389/fnhum.2014.00232.
48. Sone D. Neurobiological mechanisms of psychosis in epilepsy: Findings from neuroimaging studies. Front. Psychiatry. 2022;13:1079295. https://doi.org/10.3389/fpsyt.2022.1079295
49. Takeda K, Yamashita S, Taniguchi G, Kuramochi I, Murakami M, Kashiwagi H, Hashimoto R, Hirabayashi N, Okada T. Criminal victimization of people with epilepsy: Sixteen criminal judgments in Japan between 1990 and 2019. Epilepsy Behav. 2021;118:107912. https://doi.org/10.1016/j.yebeh.2021.107912.
50. Treiman DM. Epilepsy and violence: medical and legal issues. Epilepsia. 1986;27(2):77-104. https://doi.org/10.1111/j.1528-1157.1986.tb05742.x.
51. Tricasi G.C. Criminology: Criminal profiling. 2021.
52. Younus M, Rasheed M, Lin Zh, Asiri SA, Almazni IA, Alshehri MA, Shafiq S, Iqbal I, Khan A, Ullah H, Umair M, Waqas A. Homozygous Missense Variant in the N-Terminal Region of ANK3 Gene Is Associated with Developmental Delay, Seizures, Speech Abnormality, and Aggressive Behavior. Mol Syndromol. 2023;14(1):11–20. https://doi.org/10.1159/000526381
53. Zhang-James Y, Fernàndez-Castillo N, Hess JL, Malki K, Glatt SJ, Cormand B, Faraone SV. An integrated analysis of genes and functional path- ways for aggression in human and rodent models. Mol Psychiatry. 2019;24(11):1655-1667. https://doi.org/10.1038/s41380-018-0068-7. Epub 2018 Jun 1.
54. Zimmer A, Youngblood A, Adnane A, Miller BJ, Goldsmith DR. Prenatal exposure to viral infection and neuropsychiatric disorders in offspring: A review of the literature and recommendations for the COVID-19 pandemic. Brain Behav Immun. 2021;91:756-770. https://doi.org/10.1016/j.bbi.2020.10.024.
Review
For citations:
Musina G.M., Voronkova K.V., Petrukhin A.S. Epilepsy and criminal behavior (review of literature). V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY. 2025;59(1):8-17. (In Russ.) https://doi.org/10.31363/2313-7053-2025-1-934