Seizures hard to fake, could be caused by stress

SALT LAKE CITY — Tuesday's dramatic events in U.S. District Judge Dale Kimball's courtroom with Brian David Mitchell suffering an apparent seizure had some people wondering whether the man accused of kidnapping Elizabeth Smart could have been faking his illness.

Dr. Tawnya Constantino, a neurologist at Intermountain Medical Center was not involved in Mitchell's treatment and could not speak directly to Mitchell's condition.

In general, however, she said that most people think of convulsions when they think of seizures.

"They think of somebody who passes out, stiffens, shakes," she said.

But seizures can happen in both mild and more dramatic forms, Constantino said, and are more common than most people think. Seizures are like electrical storms, she said, and can potentially leave a person unconscious.

Before a person has a seizure, the victim will tense up, air is forced out and the person can have a "very loud vocalization or moaning cry that is the onset or first sign they are going into a seizure," she said.

Mitchell was seen tensing up when he let out a loud moan Tuesday morning before he collapsed and others helped gently lay him on the floor.

People who have had seizures in the past and let them go untreated are "very at risk for having more convulsions, and over time that can put them at risk for damage to their brain," Constantino said.

Smart testified during the early days of the trial that Mitchell suffered a seizure in 2003 while she was being held captive in California. Mitchell's stepdaughter said outside court Tuesday that Mitchell has been having seizures every few months for the past year.

Constantino said there is something called psychogenic attacks that look like seizure episodes, but generally happen in people who do not have epilepsy. They are also events that are not voluntarily triggered by the patient, she said.

Many times what causes those, Constantino said, is part of the "complicated mind-body connection." People who have psychogenic attacks often times have extensive stress in their lives, some past trauma or deep emotional trauma they're dealing with, she said.

People who have a history of depression are also more at risk for epileptic seizures.

After suffering a seizure, most people can be back to normal within 24 hours, Constantino said.

To an expert, Constantino said it would be almost impossible to fake a seizure, especially a big one. There might be a better chance of faking a mild seizure, such as people who just appear to stare off for several minutes, she said.

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