Take Another Look: Police Response to Seizures and Epilepsy

'The Person, Not the Condition'

Why do law enforcement officers become involved with people who have seizures?

People may be afraid of seizures. When they see a generalized tonic clonic (grand mal) convulsive seizure, they will either call the rescue squad, an ambulance, or the police. Sometimes they call both or all three.

If the seizure is a complex partial seizure that affects awareness and produces trance-like, odd behavior, or the shouting, running seizures that occasionally occur, people may feel threatened. They may see them as evidence of substance abuse, or mental illness. The result is, they call the police.

Sometimes police are called to a domestic dispute, and one of the partners will have a seizure, perhaps because of stress, perhaps because of prior alcohol use, or just because he or she has epilepsy. Or another family member may have a seizure while the police are there.

Sometimes, confusion and occasional belligerence in the period immediately following a seizure is seen as threatening by others, producing a call to the police.

Occasionally, behavior during a seizure is misinterpreted as criminal. Someone in a self service store may pick up an article, go into a seizure, and wander out into a mall area while still under the influence of the seizure activity. To the security people, that action may look like shoplifting, even though there is no effort to conceal the merchandise.

What types of behavior are seen during a seizure or following a seizure

Generalized tonic clonic (grand mal) seizures produce the following symptoms:

• a cry at the start caused by air being forced out of the lungs by contracting muscles
• fall to the ground, followed by stiffening of the body
• rhythmic muscle contractions of the whole body, which gradually slow down and then stop
• temporary cessation of breathing and possible development of a bluish tinge to the skin
• slow return of consciousness, accompanied by noisy breathing
• post seizure confusion, fatigue, temporary inability to respond
• in some people, belligerence and irritability following the seizure.

In complex partial seizures, a whole range of unusual, involuntary behavior is possible.

Common Symptoms

• Starts with a blank stare, followed by chewing or twitching movements of the mouth or face
• Communication blocked or disordered
• May mumble, looks dazed. Unaware of surroundings. May sometimes understand spoken word but be unable to respond
• Actions appear clumsy, not directed. May wander without regard to location or barriers in path. May make repeated movements with part of the body, or fumble with clothing
• Actual seizure lasts a couple of minutes, confusion remains for up to half an hour afterwards

Less Common Symptoms

• Screaming, crying moaning, laughing, apparent fear, running, loss of bladder control, disrobing, flailing or unnatural looking movements of arms and legs, spitting, shouting, abusive statements. This is just a partial list. Just about any movements the brain can produce normally it can produce during a seizure – except exercise direction and control.

Following either type of seizure, the following behaviors are common:

• confusion
• excessive fatigue
• irritability
• inability to remember events during or prior to the seizure
• fear

Where do encounters take place?

Seizures can occur anywhere. Many occur at home in settings that would not lead to police interaction. Seizures are more likely to come to the attention of law enforcement when they happen at locations like the following:

• in the street near the subject’s home
• restaurants
• any public place
• stores or malls
• recreation centers
• in custody
• during police questioning
• in police cruisers on the way to jail
• at the site of an accident or other stressful event
• at the bank or post office
• at a half way house or homeless shelter

When do encounters occur?

Encounters can take place at any time during police shifts. Seizures caused by alcoholism or illegal drug use may be more likely to occur during the evening hours. People who have seizures because they’ve run out of medication may be slightly more likely to do so during weekends or holidays.

What are some of the common characteristics of people with seizure disorders encountered by the police?

There are no common characteristics other than the seizures themselves.

The condition can affect the well off, the middle class, and those living on the fringes of society. Where the seizure occurs as well as what it looks like may have an effect on police response.