Greater Understanding Of Epilepsy Urged

Press, Volume XCIX, Issue 29220, 2 June 1960, Page 17

Greater Understanding Of Epilepsy Urged

A plea for more understanding of the epileptics* problem in the light of modern knowledge was made by Dr. Gavin Glasgow, of Auckland, in an address reported in the “New Zealand Medical Journal.”

Although the improvement in medical treatment in the last* 20 years should now enable the majority of epileptics to take a normal place in society, he said, they were still faced with much prejudice and misapprehension. It was inevitable that the law must interest itself in epilepsy and the epileptic, said Dr. Glasgow in his address, which was given at a meeting of the Auckland Medico-Legal Society. Even today devils might be found in possession of the epileptic. Their usual names were “resentment,” “frustration.” “bitterness” and “loneliness’” Were there any alterations which should be made in the law of the land which might help to drive them out?

Approximately one in 200 persons suffered from epilespsy in some . form at some tune during his life. Epilepsy was one of the commonest major medical problems, said Dr. Glasgow

Brain Misbehaviour Causes of epilepsy were as various as its manifestations. Any insult to the brain might render it liable to misbehave from time to time in this way. Of patients in whom no cause could be found, about 20 per cent, would be closely related to one or more other epileptics. There was no doubt that hereditary factors were important in many instances.

Uninformed recognition of this fact had been taken by the law in a number of states in the United States. In 17, marriage was forbidden the epileptic and any marriage contract was void. In six states to marry thus constituted an actual crime. Dr. Glasgow continued. Modern surveys showed that only one in 40 of the children of an epileptic and a normal person would develop the disorder. Conversely, only one epileptic in 25 had a parent similarly affected. In Dr. Glasgow’s opinion there was no adequate reason for advising against marriage between an epileptic and a normal person with a history of epilepsy. Injury Cases The main medico-legal problem concerned the incidence of epilepsy after a closed or blunt head injury—where there was only bruising or laceration of the scalp together, perhaps, with a crack in the bony skull but no displacement of the bony fragments. The figure of 2 per cent, might be accepted as the general incidence of epilepsy after closed head injuries such as were so frequently sustained in car accidents and industrial injuries. If a person did develop epilepsy. he would face the two

common problems which beset all epileptics. He might have difficulty in keeping his job or finding suitable employment and he would be debarred from driving a car. There was no doubt in his mind, said Dr. Glasgow, that those liable to epileptic attacks of any kind should not drive a powered vehicle. Cause of Accidents

In three and a half years of medical practice in Auckland he had come across no fewer than 12 car accidents—all minorcaused through epileptic attacks. In the majority of cases the driver had been Unaware that the two or three blackouts he had had in the preceding months were epileptic in nature. Dr. Glasgow said he considered the holder of a driver’s licence who developed epilepsy should be required to surrender his licence forthwith and declare the reason for its surrender. He should not reapply for his licence until two years had elapsed and his application would have to be supported by a medical certificate.

A provisional licence should be issued subject to review every six months for the next three years. In that way the doctor’s responsibility would be shared. Dealing with epilepsy as a defence against a criminal charge. Dr. Glasgow said it was during a state of post-epileptic confusion induced by the actual epileptic attack, then over, that behaviour which might lead to a criminal charge might occur. The defence that an alleged crime was committed in such a state was called automatism. Socalled automatism might arise from several other causes.

He had looked up the law dealing with automatism. It was clearly a complex problem and its legal implications had not necessarily reached final stability. It was clear that the defence of automatism was no primrose path to an unqualified acquittal.