There is high crime and mental disorders in the Transkei region of South Africa. Many of them are guilty but mentally sick. The mentally sick may be perpetrator of crime or vice versa. The mental sickness may not used as a defence. If it is used, then confined to serious offences such as murder. This is because it is not very well known among public as well as in custodian of law enforcement, result in serious consequences. This case report was a young male who was suffering from epilepsy, and beaten his mother and a neighbour inadvertently. He was charge for his crime and taken into prison. He was devoid of anti-epileptic treatment in the prison, and resulted into coma. He was treated successfully in Umtata General Hospital, and then referred to prison hospital. Again, there was lack of care, ended into status epilepticus, and death. The history of the case along with its management and lack of care has described. The rule of diminished responsibility was not exercised is discussed