Take Another Look: Police Response to Seizures and Epilepsy

Recognizing Seizures

Generally, what is known about people with epilepsy?

In general, people with epilepsy:

• Are indistinguishable from people who do not have epilepsy unless a seizure is taking place or has just taken place.
• Are generally as intelligent, perceptive and articulate as any other member of the public, although occurrence of a seizure will mask these attributes until the person is fully recovered.
• Are employed and maintain the same kind of social and familial relationships as other people do.
• Are unable to interact with other people or to respond appropriately to the environment during a seizure. They often cannot follow directions, converse with others, and are generally out of touch with reality until the episode ends and normal brain activity returns.

However, some people with epilepsy may have other physical disabilities – including mental retardation, cerebral palsy, autism, or mental illness – or they may experience social problems such as poverty, homelessness, drug addiction, or alcoholism. Because these problems may interfere with consistent access to seizure-preventing medicines, this population may be more likely to have seizures than other people with epilepsy and to have them in settings or circumstances that will lead to police attention.

What are the observable differences between mental illness and a seizure?

Mental illness tends to be a constant problem, or changes relatively slowly. People with epilepsy will experience a sudden change from normal to impaired.

People who are mentally ill will be able to interact with the officer on some level. During a generalized tonic clonic or complex partial seizure meaningful interaction with an officer, or anyone else, is unlikely. Speech, comprehension, and information processing are all affected by seizure activity in the brain.

What are the observable differences between intoxication and a seizure?

Intoxication has a slow, observable onset. Seizures arise abruptly from normal state.

Intoxicated people will have a strong smell of alcohol present; someone having a seizure may or may not have had an alcoholic drink prior to the seizure, but the presence of alcohol will not be as pronounced. However, a seizure can occur in alcoholic persons. When it does, it should be managed in the same manner as one in a non-impaired individual – that is, by protecting from injury, not applying forcible restraint, and helping to re-orient to surroundings following return of consciousness.

Police can have interaction with an intoxicated person who may be impaired; however, despite slurred speech, inappropriate behavior and a staggering gait, communication can take place on some level. Interaction is usually not possible with someone who is having a seizure until the seizure is over.

What indications exist that behavior which initially appears to be criminal is in fact seizure-induced (such as disrobing or leaving a store without paying or trying to get into someone else's car, residence or office)?

In someone who has had or is having a seizure, the level of awareness will be affected so that:

• response is impaired
• there's a vacant stare
• inability to speak
• confusion
• no effort to hide unpaid-for merchandise
• clumsy, disoriented movements in removing clothes
• primitive, non-directed movements in opening closed doors

Other signs suggesting a seizure may be responsible include:

• presence of medical ID for epilepsy or seizure disorders
• presence of epilepsy medicine
• information from bystanders