South Africa - Martin, 55, Theresa, 54, Rudi van Breda, 22, murdered, 26 Jan 2015 #4

[JudgeJudi]

Did #VanBreda in your opinion suffer loss of consciousness or loss of memory? Dr Butler says lying on stairs means not simply amnesia. For him to lie there for 2h40m means more than amnesia; unconscious, largely doesn't move. Could be a seizure of 2m and severe postictal period.

Can't see any evidence that contradicts that he laid on stairs, Butler says.

Fits with medical knowledge of person who had lost consciousness.

Desai: All you're saying is its possible.

[url]https://twitter.com/TeamNews24[/URL]

Desai raises the spectre of whether Henri did lie on the stairs, or not. "You can't say that he lay on the stairs for a fact." Butler: "No...from the report from him..."

[url]https://twitter.com/HiRezLife[/URL]

Dr B: I am only relying on what was given to me to compile the report I have not considered all of the evidence.

[url]https://twitter.com/CapeTownEtc[/URL]

 

[JudgeJudi]

No other medical reason other than epileptic seizure?

Butler says epilepsy and malingering are in the room. One of the guys is guilty.

The accused denies having suffered petit mal seizure? Yes, Butler says.

[url]https://twitter.com/TeamNews24[/URL]

Galloway notes staring, smacking of lips etc. Butler describes these as absence seizures. What about fluttering of eyelids. Interesting. Galloway now referring to some of Henri's behaviour in court, which as it happens, is on the livestream and predates his Nov 8 fit.

Butler refers to impact on quality of life for epileptics, even when seizures are mild, as significant. Yes.

GALLOWAY: Henri denies ever having suffered these kinds of seizures in the past. Only happening now. [So didn't have an impact on him studying in Melbourne, or not studying, according to Henri.]

[url]https://twitter.com/HiRezLife[/URL]

 

[JudgeJudi]

Dr B: if you go to a job and you have a few absences, the impact on their quality of life is substantial - every absence is severe- depends on the impact of their quality of life

Dr B: during peti mal seizure forward and back but not all movement would seize its a question of degree of malfunction in brain

Adv G: but he never said he remembers having a petit mal seizure? Dr B: yes but as an aside if they do not notice something wrong with a discharge it does not necessarily mean there was no discharge

Desai: is there a likelihood, assuming there was attack in 2015, that prior to that he did not have it? Dr B: no thats potentially flawed he may have had discharges prior to that which nobody knew of

Desai: prior to these, no clinical seizures in earlier stages? No noticable or significant seizures prior to 2015?

Desai its safe to assume because of his background if he had had an attack it would have been picked up? Dr B: if he waas with someone and had grand mal yes if in his sleep no. Mycolon nobody may have known

Adv G: jerking movements of arms and legs is a myclonic seizure Dr B: they could be unrecognised if you spill a cup of tea you put it down to being clumsy but it may be myclonic seizure

[url]https://twitter.com/CapeTownEtc[/URL]

 

[JudgeJudi]

You don't one day develop epilepsy and before that there's nothing happening, Butler says. Desai asks if prior to known instances, there were no noticeable or significant seizures? No, but may have happened in his sleep.

VanBreda has myoclonic seizures while awake, Butler says.

If seizure is longer than 5 minutes, you are in a continuous seizure, considered a medical emergency.

[url]https://twitter.com/TeamNews24[/URL]

Did Henri not know he had epilepsy? Did his family not know?

[url]https://twitter.com/HiRezLife[/URL]

Adv G: This is the type of seizures he has? Dr B: yes we have recorded and unsolicted history confirms.

Adv G; the tonic clonic seizures always known as grand mal seizure? Do these develop?
Dr B: there is no pattern there is nothing to say that you have to have one but most often with hindsight you realise been there for a while

Adv G: so most of these grand mal seizures last 3 min? Dr B: majority of patients would experience that time but several out of 100 would have a seizure longer than 5 min

Adv G: but if it extends longer than 5 min that is a medical emergency? Dr B yes if you reach 30 minutes without medical intervention, serious medical emergency

Dr B: if you have 30 min and you have seizures but do not regain consciousness in between the seizures that is regarded as state of medical emergency

Desai its safe to assume because of his background if he had had an attack it would have been picked up? Dr B: if he waas with someone and had grand mal yes if in his sleep no. Mycolon nobody may have known

[url]https://twitter.com/CapeTownEtc[/URL]

 

[JudgeJudi]

Dr B: some exclusively have seizures when sleeping and some only or largely have their seizures after waking

G: a cluster of seizures may be a warning of upcoming tonic clonic seizure?

Dr B: the clustering when it happens we will give you meds to take leading up to that to avoid trouble which is likely coming and you preventing hospitalisation

JME - one in 6 only have myclonic and not necessarily the grand mal. Dr B: no I would very much doubt that statement it is uncommon to exclusively see people with only myclonis

[url]https://twitter.com/CapeTownEtc[/URL]

 

[JudgeJudi]

Adv G: what causes it? Genes? Dr B: we don't know what causes before we have done the tests sometimes you do the tests and you find a tiny little birthmark on the brain and then you know, we find the cause through investigations

Dr B: in general - genetic and aquired - acquired when you have had meningitis, brain trauma etc.

Dr B: with benefit of hindsight you can track it back but many cases patients have it for decades without knowing

Adv G: what appears to be more certain is that certain events bring on a seizure- Dr B: correct they precipitate and invoke it, you have the disposition and something brings it on

Adv G: most common is lack of sleep and too much stress although stress not necesarily supported by clear scientific facts

Dr B: there is some evidence but science is objective and we have some tests to show stress is a cause

G: and then alcohol consumption? Dr B: together with sleep, if you shift your bed time from 10pm to 3am you disturb that and it predisposes you to a higher risk

[url]https://twitter.com/CapeTownEtc[/URL]

 

[JudgeJudi]

Galloway says there is evidence that certain things or events tend to bring on a seizure? Butler: yes, they provoke it.

Most common causes of seizures are lack of sleep and too much stress, and also flickering lights and watching too much TV? Correct.

[url]https://twitter.com/TeamNews24[/URL]

Dr B: it wont happen every time you stress or are deprived of sleep or have a couple of drinks- the thresholds vary

Dr B: often have myclonic after partying too much

Adv G: the afte math- Dr B in a grand mal after the seizure your brain is flat and you cannot regain consciousness - initially flat and then waves start slowly in the brain, brain waves speed up and at some point person wakes up

Dr B: sometimes minutes or hours- its variable but it is slow

Dr B: this is only in a grand mal in a myclonic seizure you don't lose consciousness

[url]https://twitter.com/CapeTownEtc[/URL]

 

[JudgeJudi]

In postictal state each function may recover at different rates, you can still walk but appear drunk and your higher order functions are not working properly

Adv G: other symptoms- feelings of drowsiness? Dr B: yes either disoriented or tired some get severe head aches nauseus

Adv G: only putting to you as a possibility- if I was able to get all this information on epilepsy the accused has access to the internet and would be able to get this information? Dr B: yes ofcourse - encourages access to this knowledge

https://twitter.com/traceyams?lang=en

Cognitive functions returns gradually after a seizure. When you wake up you feel drowsy, groggy, disorientated, Butler says.

Galloway: if I was able to get this information from the internet, the accused would also have been able to? Correct, Butler says.

Desai: in this case the girlfriends father was a doctor too

G: one of the most common results is urinating? Dr B: correct or biting your tongue

G: Likelihood of accused suffering an epileptic seizure out of the blue 0.05%?

G given his age, his having a seizure out of the blue is a fraction of the 0.05%? Dr B on the assumption of him never having had any Dr B: correct

Adv G: U make mention of malingering in your report but most of what you say is based on the accuseds history

[url]https://twitter.com/TeamNews24[/URL]

 

[JudgeJudi]

GALLOWAY: If I got all these questions from the internet, then the accused could too. Butler: Unquestionably. Wow.

Your chance of having a big seizure out of the blue is 0.5%... What about the chance of having 2 seizures out of the blue, at very strategic times?

Galloway now reviewing Henri's medical history. Important.

https://twitter.com/HiRezLife

Dr B: there ar a number of factors and I am happy to run through them
Desai: no no thank you!

Dr B: I was focused on his brain function

Adv G: when you regard the photos of him in the ambulance

Desai: did he use the word intruder or intruder/s?
Dr B: I put it to him after the intruder left the house what happened, that is what was put to him I can vouch for that

Adv G: You refer to his bruise and rings under eyes? Can that be lack of sleep? Dr B: I don't know about the scientific evidence on that I know that is a lay persons impression, I plead ignorance in that respect

Adv G: he appeared dull? Could that be as result of trauma? Dr B: the facial expression is an appearance I have seen but it does not prove it

Dr B: I would not place alot of evidence on the facial expression

Dr B: He had a generalised tonic clonic seizure in February 2016, highly likely

Adv G: and the 8 November 2017 seizure? Dr B: that was a tonic clonic seizure

https://twitter.com/traceyams?lang=en

 

[JudgeJudi]

Photos of #VanBreda in ambulance. Could rings under eyes be caused by lack of sleep? Butler doesn't know scientific answer. Bruise could be blow with a fist? Dull could be a result of trauma? Butler says he has seen this in postictal state, but doesn't prove. Subjective view.

Butler says #VanBreda relayed he had started getting twitches early 2015. He fobbed it off, couldn't be more precise of when they presented.

[url]https://twitter.com/TeamNews24[/URL]

So he had big seizures - so why was he driving?

[url]https://twitter.com/HiRezLife[/URL]

Adv G: The two tonic clonic and the myoclonic seizures were the only ones reported to you and based on symptoms

Adv G: why was the first one early 2015? Dr B: that is all he could recall could be January could be march we dont know. Adv G so no spontaneous history of seizures before Fe 2016. Dr B: correct

Dr B as you can see the gran mal seizures occurred very far apart. Adv G: his girlfriend only came into his life in February 2016 so prior to that you only rely on Henri's version with regard to possible seizures prior

[url]https://twitter.com/CapeTownEtc[/URL]

 

[JudgeJudi]

Dr B: a malingerer would draw attention to the symptoms, here his girlfriend noticed them her father is a GP and they put it down to excessive alcohol

Desai: why did the father recommend you now and not then? Dr B: I dont know cause it is the second time perhaps? Desai but when he called you he was aware that you were a neurologist? Dr B: correct. I dont know how he found me

Adv G: you are not only the first recorded diagnosis of the illness but the first recorded history of the illness.

Dr B: to the best of my knowledge there was no medical intervention around that event Adv G: so Henri is the only source of the history prior to Feb 2016? Dr B: correct.

[url]https://twitter.com/CapeTownEtc[/URL]

Dr Butler says a malingerer tends to draw attention to symptoms. #VanBreda's girlfriend's father is a GP, but HvB still fobbed it off.

[url]https://twitter.com/TeamNews24[/URL]

Court adjourns for lunch

 

[JudgeJudi]

Gosh, that was fast and furious this morning. Time for a nice hot cuppa.

 

[Bohemian]

Gosh, that was fast and furious this morning. Time for a nice hot cuppa.

I’ll put the kettle on. Thanks JJ x

 

[Interested Bystander]

Well done JJ.

Can you think of how else this information can help the Defence, other than by rejection of the police statement due to his postictal state and the explanation for the time gap before he called the emergency services?

I don't feel anything we have heard in the last two days alters the fact that he was the only person who could have murdered his family.

 

[JudgeJudi]

I’ll put the kettle on. Thanks JJ x

I wish Prime was here to serve us up some lovely cakes. I miss them, and her.

 

[JudgeJudi]

Well done JJ.

Can you think of how else this information can help the Defence, other than by rejection of the police statement due to his postictal state and the explanation for the time gap before he called the emergency services?

I don't feel anything we have heard in the last two days alters the fact that he was the only person who could have murdered his family.

Not that I can think of at the moment. I'll digest it all tomorrow morning but I think it's only the 2hrs 40 mins, and that was after the event.

 

[JudgeJudi]

If this was a strategic move by the defense - and I believe it was - then rushing the neurologist through Henri's history via Henri might have a secondary goal. If the history is provided by Henri & with very little time, the odds of overlooking aspects of it are high.

https://twitter.com/HiRezLife

 

[JudgeJudi]

I don't get too much of an opportunity to take everything in when posting the tweets, but I have an overriding impression that Desai isn't buying Butler's facts/theories. Does anyone else think the same?

 

[JudgeJudi]

O/T If anyone here is following Rohde, there's a swag of new tweets.

 

[Hag]

I don't get too much of an opportunity to take everything in when posting the tweets, but I have an overriding impression that Desai isn't buying Butler's facts/theories. Does anyone else think the same?

That has been my impression also. Boom moment when Galloway suggested possibility HvD could have googled epilepsy, as did she. Obvious of course.