Dr James Butler, a neurologist, testified in the Western Cape High Court triple murder trial of Henri van Breda on Monday. Photo: Catherine Rice / ANA

Cape Town - The evidence that triple murder accused Henri Van Breda has epilepsy is "unambiguous", a neurologist testified in the Western Cape High Court on Monday.

The trial of the 23-year-old stood down two weeks ago when the court heard that Van Breda had a seizure on November 8. He spent the weekend in the hospital where he underwent a series of tests and was diagnosed with juvenile myoclonic epilepsy.

Dr James Butler told the court that given the media attention, in this case, he had instinctively considered malingering, a feigning of illness for secondary gain.

Read: Family was aware of Van Breda’s seizures

But, after admitting Van Breda to the hospital for the weekend, he had no doubt about his diagnosis: "Turns out he had had three major seizures. Nothing in life is certain, but it is highly likely he has juvenile myoclonic epilepsy". 

Electrodes recording the brain's electrical activity for 24 hours and heart monitors were attached to Van Breda. Spikes appearing on the EEG  (electroencephalogram) were strongly predictive of epilepsy, Butler told the court. 

Butler believes Van Breda has had epilepsy for several years, and when questioned about the severity of the seizures by Judge Siraj Desai, conceded that it doesn't impair one's daily functioning.

Van Breda is nearing the end of his mammoth trial for allegedly killing his mother, father and brother and severely injuring his sister in a vicious axe attack at their family home in Stellenbosch in January 2015.

Read more: Unexpected last-minute defence witness stalls #VanBredaTrial

He claims an intruder, armed with an axe and a knife, and wearing dark clothing, a balaclava, and gloves, was behind the attacks. He said, in his plea explanation, that during the pursuit of the attacker he lost his footing and fell down the stairs. He added: "I do not know what made me fall, but my fall was quite severe". 

After the attacker fled and trying to phone his girlfriend without success, the accused said he went up the stairs, where he could hear his brother Rudi in the bedroom. On the middle landing towards the top, he saw his sister Marli moving. 

"I then lost consciousness. I am unsure whether this was due to shock or to the injuries that I sustained when I fell down the stairs, or a combination of both".

Dr Butler's testimony could account for Van Breda's memory loss during the 2 hours 40 minute time lapse.

He told the court that Van Breda's girlfriend described an event in February 2016 in which they were discussing the court case and Van Breda became emotional: "She could see he was shaking but couldn't see his face as it was dark. He appeared out of it and very tired once it was over".

Butler said Van Breda's girlfriend had reported "several episodes of memory loss" but put it down to drinking too much alcohol.

She told Dr Butler that on November 8 Van Breda had "abruptly lost his memory". 

"She reported he looked like he was about to cough and fell backwards, his arms and legs shaking for about one minute." 

Butler said she described his face as red and his jaws were clenched.

"She said his breathing was very noisy. When he regained memory, he was light-headed and very tired. When the seizure ends the dysfunction in the brain doesn't stop. The brain typically takes several hours, sometimes days to recover". 

Butler said he questioned Van Breda about his memory loss on the night of the murders and said he recalled seeing his sister moving at the top of the stairs. 

"He then abruptly lost his memory. Furthermore, he said it was dark outside before he lost his memory." Van Breda noticed it was light outside when he woke up and was disorientated, Butler told the court.

Butler also commented on a photograph of Van Breda taken in the ambulance.

"He looked considerably dulled to me. It is certainly strongly consistent with the appearance of someone recovering from a seizure, as the brain is not working well."

The trial continues.