INTRODUCTION: Epileptic patients charged with a serious offense may be referred by courts for forensic psychiatric examination, which may pose a legal challenge. Therefore, a detailed examination is necessary to assist the courts in making the right decision.
METHOD: We present the case of a 30-year-old Tunisian male with temporal epilepsy who exhibited an inadequate response to the treatment. The patient attempted to kill his neighbor after a cluster of seizures, showing apparent post-ictal aggression. An anti-epileptic treatment was reintroduced a few days after the detention followed by forensic psychiatric examination three months afterwards.
RESULTS: On the forensic examination, the patient's thought process was clear with no evidence of a thought disorder or a psychosis. Both medical and psychiatric opinions stated that the attempted homicide was due to a post-ictal psychosis. The patient was transferred to a psychiatric facility for further management as he was found not guilty by reason of insanity.
CONCLUSION:This case report illustrates the difficulties that experts may encounter in establishing criminal liability after an aggressive behavior associated with epilepsy. It highlights some shortcomings in theTunisian law that should be addressed to ensure the fairness of the legal process.