Daniel’s mother saw him off to school as usual one morning. He took his normal route, dawdling and stopping as he usually did, to look at the mountain bike he hoped to get for his birthday in the showroom window, so that he was overtaken, by his form master.
‘Morning Daniel. Are we going to see you on time this morning, do you think?’
‘I expect so, Mr Phelps. I’ll be along in a moment.’
But Daniel wasn’t along in a moment. When, by assembly time, he still hadn’t turned up, Mr Phelps was worried. After assembly he went to the headmaster, who phoned first Daniel’s parents, and then, when it was discovered that he hadn’t gone back home, the police.
In fact it was Daniel’s father, driving desperately around the town searching for his son, who spotted him some three quarters of an hour later. He was standing on a bridge, looking down into a river.
‘Daniel! What happened to you? Where’ve you been?’
Daniel looked bemused.
‘What time is it, Dad? Oh gosh, not 10 o ‘clock. I’ll be late for school again.’
Daniel remembered talking to Mr Phelps. But after that he had no memory of what had happened to him until he found himself looking down into the river. During that time he had walked about two miles and crossed several quite busy roads.
Daniel’s is a fairly unusual case of epileptic automatism after a complex partial seizure, but it is not that unusual. There are numerous examples of people performing complex acts in a state of confusion, during or immediately after a seizure, usually a generalized or complex partial seizure. Most of these automatisms are brief, lasting only a few seconds. They seldom last longer than a few minutes but can, rarely, continue for as much as an hour.
If someone had stopped Daniel and spoken to him while he was wandering through the town they would have noticed that he seemed out of touch with his surroundings, and looked dazed or vacant. Daniel would probably not have responded if he had been spoken to, or he might have given some incoherent or irrational reply.
However, an epileptic automatism is usually less dramatic than Daniel’s experience. The person is more likely to perform simple, repetitive, rather clumsy movements. They may pull at their clothes, repeatedly rub their face or fiddle with something. Sometimes they may perform more complex actions, such as walking about the room, searching for something in a drawer, dressing or undressing. But only occasionally is an automatism, like Daniel’s, so seemingly purposeful and coordinated that it is difficult to believe that it has been carried out entirely automatically, in a state of such deep confusion that the person does not realize what they are doing and afterwards has no memory at all of what they have done. My own favourite account of an automatism concerns an organist who had an attack while playing the organ in church for a carol concert. He suddenly stopped playing, gave the congregation three minutes of uninterrupted jazz, and then, the seizure over, continued with the carol he had been playing as though nothing had happened.