The lawyer for a Dutch neurologist convicted of deliberately giving inaccurate diagnoses including of Alzheimer's disease and multiple sclerosis to several patients said Monday his client has brain damage that could have affected his actions. 

Lawyer Peter Plasman made the claim on the first day of an appeals hearing in the medical malpractice conviction of disgraced doctor Ernst Jansen Steur.

The case is one of the biggest medical negligence prosecutions in Dutch history. Jansen Steur also practiced in neighboring Germany.

The prominent neurologist was convicted last year of harming the mental and physical health of eight patients by treating them for diseases they did not have. One patient took her own life as a result of the false diagnosis, believing that she was in the terminal phase of an illness.

Jansen Steur was sentenced to three years in prison. He is appealing his conviction and prosecutors are appealing, saying he should be given a longer sentence. Prosecutors sought a six-year prison term at his trial.

As well as causing psychological suffering in patients who believed they had a degenerative neurological disorder, Jansen Steur also prescribed them medication with serious side effects.

Plesman said a car crash 25 years ago left the neurologist with brain damage that has only recently been diagnosed.

"My client has been diagnosed with a frontal syndrome," Plesman said. "He and all the people around him are convinced that his behavior has been determined by this, now and in the past."

Jansen Steur, who also has been diagnosed with a narcissistic personality disorder and was addicted to prescription sedatives at the time of some of his false diagnoses, did not attend Monday's hearing in the eastern city of Arnhem.

One of his victims cast doubt on the brain-damage claim.

"Someone who has suffered brain injury after a collision isn't eight years OK, three years not OK and the next eight years fine again. I do not understand this," said Joke Prins, who was misdiagnosed with multiple sclerosis in 2003.