What Should a Criminal Defense Attorney Know About Seizures?

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Courtesy of Godoy Medical Forensics

 

Causes

  • Toxicology:
    • Seizure medication noncompliance;
    • Certain Medications: Tricyclic Antidepressants, anticholinergics, and lithium;
    • Overdose or withdrawal from many other medications/substances;
    • Poisoning, such as pesticides or other substances.
  • Medical conditions:
    • Brain conditions, such as hydrocephalus, tumors, and stroke (can be delayed);
    • Traumatic brain bleed (can be delayed);
    • Pregnancy complications;
    • Kidney failure;
    • Electrolyte imbalance, especially sodium andpotassium;
    • Low blood sugar (diabetics and non-diabetics);
    • Psychogenic (pseudo seizures).

Medical History

A person with no history of seizures can have a seizure at any time. People with a history of seizures that have not had a seizure for a long time can still have a seizure at any time. People on medications for seizures can have “break-through” seizures at any time.

Types of Seizures

  • Grand mal seizures are the most obvious because the entire body convulses and loss of consciousness occurs. Common symptoms are incontinence and biting of the tongue.
  • Partial seizures affect only one part of the brain. Such seizures can present as a focal seizure to one limb, a change in sensation or emotion, or a change in speech. These are very difficult to diagnose because the symptoms may be very subtle.
  • Absence seizures present as “spacing out” and the person is not aware of their actions during that time. The person may be completely functional (can walk, talk, etc.) An observer may not necessarily know the person is having a seizure.

Occurrence

A person with no history of seizures can have a seizure at any time. People with a history of seizures who have not had a seizure for a long time can still have a seizure at any time. People on medications for seizures can have “break-through” seizures at any time.

Auras

Auras are a warning sign that a seizure is coming on. Not everyone gets auras. Auras can present as a headache, an odd taste in the mouth (like metal), vision changes, etc. Everybody’s aura is different and it can be anything.

Post-Ictal Period

The “post-ictal period” is the time frame after the seizure when the body and mind are recovering from the seizure. People may appear intoxicated, slur their speech, demonstrate confusion, and are very commonly agitated or combative. Most post-ictal periods last about 15 minutes but they can last much longer—hours or days.

 

 

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