FORENSIC SIGNIFICANCE OF THE LIMBIC PSYCHOTIC TRIGGER REACTION

During the ''decade of the brain,'' competent expert testimony should encompass widely neglected, even novel, neurophysiologically plausible explanations for otherwise unexplainable acts. In the case presented here, a sudden, out-of-character, motiveless, unplanned homicidal atta ck was committed by a patient who demonstrated flat affect, preserved consciousness, and memory of the episode. Transient autonomic hyperact ivation and psychosis were suddenly experienced when the victim happen ed to move his mouth while eating. Following a sudden memory revival o f repetitive but moderate bodily stresses, the patient suffered viscer al hallucinations of his entire body being cut into pieces with the de lusional belief that he was about to be ''cannibalized.'' The patient' s sudden and very transient symptomatology is characteristic of 13 int errelated symptoms and signs (including autonomic, e.g., visceral, hyp eractivation and psychosis) proposed as a new subtype of a partial sei zure, called ''limbic psychotic trigger reaction,'' which has been con sistently delineated thus far in 18 white social loners (14 homicidal men, 3 fire setters, and 1 bank robber), who ruminated about past, mod erately painful, but repeated events. This rendered them liable to sei zure kindling, particularly of the limbic system. Apparently a post-ic tal transient frontal lobe deficiency is secondary to the limbic storm . The forensic impact of seizures on cognition (appreciation of the qu ality of the act) and on volition is discussed.