Henri van Breda

Cape Town - A grand mal seizure can cause amnesia that lasts for two hours and forty minutes, a neurologist testified in the Western Cape High Court on Monday.

Dr James Butler, a defence witness in the trial of triple murder accused Henri Van Breda, said a seizure could be followed by a "postictal state" which is an altered state of consciousness characterised by disorienting symptoms such as confusion and drowsiness.

He also told the court that the lack of urgency in Van Breda's voice when he made the call to emergency services could have been because he was in a postictal state.

Butler said Van Breda has a "generalised form of epilepsy" and there would therefore have been no warning that he was about to have a seizure on the night his family was attacked in January 2015.

"The abruptness of the onset of amnesia is highly significant -- the only culprit left standing is epilepsy".

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 hospital where he underwent a series of tests and was diagnosed with juvenile myoclonic epilepsy.

Read: Neurologist certain of #VanBreda epilepsy diagnosis

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

But, after admitting Van Breda to 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 myclonic epilepsy". 

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

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

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.

He claims an intruder, armed with an axe and a knfie, 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".

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."