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A Serial Murderer Learns to Regain Volition by Recognizing the Aura of His Partial Seizures of "Limbic Psychotic Trigger Reaction"

A shy serial murderer, a social loner with past head injuries and previous petit mal seizures, surrendered voluntarily after 25 years. All his homicides had been unplanned, motiveless, and committed with flat affect and during a fleeting psychosis. Both onset and cessation of the symptomatology were sudden and had progressed in three phases, implicating seizures. After recognizing the fatal meaning of his "premonition signs" (his visual aura), he was able to flee immediately and permanently from two potential further victims. His flight had also removed the impact of his individualized external trigger stimuli (demands for closeness), which previously had revived past similar stresses. Because such external stimuli are necessary for seizure kindling, the apparent seizureaborting effect of their removed impact supports a hypothesis of seizure kindling. Previously, 16 similar homicidal cases had been proposed as limbic psychotic trigger reaction. Furthermore, the volitional abortion of a seizure was not followed by an alternative psychosis or forced normalization.

Key Words: homicide • limbic psychotic trigger reaction • partial seizures • kindling • volition

Clinical Case Studies, Vol. 1, No. 4, 324-341 (2002)
DOI: 10.1177/153465002236508


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