Lord Janner could be forced to appear before a judge from his own home in relation to 22 historic child sex charges, a court heard today.

The former Labour peer and MP, whose home in West Heath Road, Hampstead, was raided in 2013 in relation to the allegations, did not attend Westminster Magistrates’ Court for an initial hearing today, with his lawyers saying he was too ill to come and may suffer a “catastrophic reaction” if produced.

But chief magistrate Howard Riddle ruled that Janner, who faces 22 charges spanning a period from the 1960s to the 1980s, did not have to understand or play a part in the initial hearing but was required by law to attend.

The district judge ruled that Janner must appear before him next Friday but asked prosecutors and defence lawyers to examine the possibility of holding the hearing elsewhere - potentially including the defendant’s home.

They will meet again on Tuesday to consider arrangements for the “novel position” the court had found itself in, Mr Riddle said.

Mr Riddle heard evidence from two defence psychiatrists who said Janner was too ill to appear.

He said that while there was “absolutely no doubt” Janner suffered from severe dementia, the section 51 hearing “does require the defendant’s presence”.

He agreed with the prosecution’s argument that many defendants find court appearances distressing and that after their initial short appearance at magistrates’ courts means were found to accommodate them.

Mr Riddle said: “I have heard evidence from the two experts that in the context of today’s hearing there is likely to be distress and that is what has been described as ‘catastrophic distress’. But what it means, as I understand it, is that the defendant may well become intolerant of the process, irritable and may indeed leave.

“I further understand, and this is very significant, it is likely to have no long-term effect on him.

“He must appear for a comparatively short period of time. He is free to go if he becomes distressed. This (hearing) will probably be achieved in less than a minute. Nevertheless the law requires his presence.”

A trial of the facts, where a jury hears the evidence against an individual considered too ill for a full trial, is expected to be held into the charges against Janner, who was suspended by Labour in April.

A judge will have to decide if Lord Janner is fit to plead. If he is not, a jury will be asked to decide whether he did the acts he is charged with.

The judge will also have to rule on whether the defendant should appear during the trial or can be excused on medical grounds.

The 87-year-old peer’s family strongly denies claims he used his power as an MP for Leicester to abuse vulnerable young boys at a local children’s home.

Mr Riddle added: “Reducing distress to a minimum is important. Something that occurred to me is whether the court should construct itself somewhere else, like Lord Janner’s house.”

However he added that this might throw up issues around open justice and Janner’s family may object, and that some other building nearby could be looked at.

“I would encourage an imaginative approach to a situation I have not come across before,” he said.

Andrew Smith QC, for Janner, had argued that the distress to his client would be “inappropriate and disproportionate to the process”.

He added that alternative measures that might be considered by the court “do not in reality ameliorate the difficulties identified by the experts”, including the duration of the hearing and the “alien” surroundings.

He said: “There is a real likelihood of a catastrophic reaction.”

At the start of today’s hearing he told the court: “Lord Janner is not in attendance. The reason for that submission on his part is that he is unfit to face the court.”

Defence medical expert Norman Poole said Janner had been a keen gardener but now “prefers to stay in a darkened room, watching television”.

“Whenever they (his carers) encourage him to go out he resists and becomes quite challenging, saying ‘no, no, no’,” Dr Poole said, adding that Janner was not violent.

James Warner, who has 20 years experience working with dementia, told the court: “There is no doubt in my mind that Lord Janner has dementia and that it is severe.”

He added that Janner’s condition was “beginning to really impact on his day-to-day life”, and that he was “highly likely to become distressed” in court.

He said the severity of dementia “would impair to a very significant extent his ability to communicate verbally” and “he would not be able to understand that he was in court”.

Dr Warner added that Janner was also showing the early signs of Parkinson’s disease.