A Note on Psychomotor Epilepsy

Since the publication of this book in its hardcover edition, several neurologists have advised me that the syndrome of psychomotor epilepsy is incorrectly portrayed in significant ways. These professionals emphasize that psychomotor epileptics are no more prone to criminal behavior than other individuals in society. They also agree that a psychomotor epileptic in the midst of a seizure is unlikely to injure anyone, except by accident. They regard complex, purposeful aggressive behavior in the course of a seizure to be either extremely rare, or nonexistent.

When pressed to explain the well-documented incidents of assault by psychomotor epileptics, these neurologists argue that such assaultative behavior, even when repetitive, sudden, and inappropriate, is not actual seizure activity. Some refer to it as "epileptiform" behavior. Others say that epilepsy per se is not the issue; they argue that any kind of brain damage - whether it produces epilepsy or not - may lead to episodic loss of inhibitions governing violent behavior.

Whether or not one finds these explanations satisfactory, it seems unarguable that most neurologists who treat psychomotor epileptics as patients have found their patients to be very different from Harry Benson in THE TERMINAL MAN. The overwhelming majority of psychomotor epileptics are not violent or sexually disturbed; their seizures are under good control, and they lead rich and rewarding lives, holding good jobs and raising families.

In the face of considerable controversy among clinical neuroscientists, I am persuaded that the understanding of the relationship between organic brain damage and violent behavior is not so clear as I thought at the time I wrote the book. I believe that this is a research area that will prove enormously fruitful in the coming years. But in the meantime, I am concerned that I may have inadvertently hampered the attempts of well-controlled epileptics to function in a society that still retains a lingering prejudice against epilepsy.

Michael Crichton

Los Angeles

December 1972