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'''Ecstatic Seizures''', |
'''Ecstatic Seizures''', |
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also called [[Dostoyevsky]]'s Epilepsy, are a type of seizure activity that is characterized by feelings of ecstasy or transcendent joy. [[Mystical]], [[spiritual]], and [[hallucinatory]] experiences often occur as well. The temporal lobe is effected by the seizure activity and may provide a neural basis for these experiences, although the exact [[neural correlates]] are debated. Ecstatic seizures may be felt as epiphanies or revelations of a deeper reality. Ecstatic Seizures are also called [[Dostoyevsky]]'s Epilepsy due to the fact that Fyodor Mikhailovich Dostoyevsky, a famous Russian novelist, short story writer, essayist, and philosopher, reported this type of seizure and also made characters in his novels that had a similar condition and experiences as him. Those with temporal lobe epilepsy normally develop [[Geschwind syndrome]], as did Dostoyevsky{{sfn|Sacks|2012|p=155-158}} |
also called [[Dostoyevsky]]'s Epilepsy, are a type of seizure activity that is characterized by feelings of ecstasy or transcendent joy. [[Mystical]], [[spiritual]], and [[hallucinatory]] experiences often occur as well. The temporal lobe is effected by the seizure activity and may provide a neural basis for these experiences, although the exact [[neural correlates]] are debated. Ecstatic seizures may be felt as epiphanies or revelations of a deeper reality. Ecstatic Seizures are also called [[Dostoyevsky]]'s Epilepsy due to the fact that Fyodor Mikhailovich Dostoyevsky, a famous Russian novelist, short story writer, essayist, and philosopher, reported this type of seizure and also made characters in his novels that had a similar condition and experiences as him. Those with temporal lobe epilepsy normally develop [[Geschwind syndrome]], as did Dostoyevsky{{MEDRS|date=November 2013}} {{sfn|Sacks|2012|p=155-158}} |
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== Introduction == |
== Introduction == |
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The term ecstatic seizure has been applied to two types of experience, often coexisting. The first is simply the experience of deep pleasure or [[Ecstasy (emotion)|ecstasy]]. The second type could be described as a pleasurable insight into the [[unity]], [[harmony]], [[joy]], and/or [[divinity]] of all reality. |
The term ecstatic seizure has been applied to two types of experience, often coexisting. The first is simply the experience of deep pleasure or [[Ecstasy (emotion)|ecstasy]]. The second type could be described as a pleasurable insight into the [[unity]], [[harmony]], [[joy]], and/or [[divinity]] of all reality.<ref name=Saver>{{MEDRS}} {{cite journal|last=Saver|first=J., L.|coauthors=Rabin, J|title=The neural substrates of religious experience|journal=J Neuropsychiatry Clin Neurosci.|year=1997|volume=9|series=Summer|issue=3|page=498-510|pmid=9276850}} See followup comment at PubMed, "religious experience was not correctly defined"</ref> The [[emotion]] of ecstasy refers to a trance like state of joy. Ecstasy may be considered a heightened sense of awareness and exceptional mental clarity with intense positive feeling. This type of experience can alter many types of [[perception]] and sometimes result in a permanent change in the subjective perception of reality. Ecstatic seizures have initially been denied of existence by respected [[epileptologist]]s, maybe due to its rarity or maybe due to the reluctance or incapability of patients to talk about hallucinations of emotion. These experiences can sometimes be described as '[[nonhuman]]', or just beyond explanation. These circumstances make it hard to document this condition and there is not a significant amount of detailed literature available.<ref name=Picard>{{cite journal|last=Picard|first=F|coauthors=Craig|title=Ecstatic Epileptic Seizures: A Potential Window for the Neural Basis of Human Self-Awareness|journal=Epilepsy & Behavior|year=2009|month=July|volume=16|issue=|pages=539–546|pmid=19836310 }}</ref> |
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Epilepsy has been associated with religion and mysticism since [[ancient]] times, and has been revered or persecuted among cultures.<ref name=Devin>{{cite journal|last=Devinsky|first=Orrin|coauthors=George Lai|title=Spirituality and Religion in Epilepsy|journal=Epilepsy & Behavior|year=2008|month=May|volume=12|issue=4|pages=636-643}}</ref> Growing interest in these types of experiences have led to new research and a new field of [[neurotheology]]. Ecstatic seizures can generate experiences of religious [[bliss]] and sensed presences. They are normally characterized by intense positive feelings and a heightened awareness of self. Time alterations have also been reported. Hyper activation of the anterior insula has been hypothesized as the cause of these experiences. Nausea, irritation of the throat, and an urge to urinate have also been reported as symptoms. |
Epilepsy has been associated with religion and mysticism since [[ancient]] times, and has been revered or persecuted among cultures.<ref name=Devin>{{cite journal|last=Devinsky|first=Orrin|coauthors=George Lai|title=Spirituality and Religion in Epilepsy|journal=Epilepsy & Behavior|year=2008|month=May|volume=12|issue=4|pages=636-643|pmid=18171635}}</ref> Growing interest in these types of experiences have led to new research and a new field of [[neurotheology]]. Ecstatic seizures can generate experiences of religious [[bliss]] and sensed presences. They are normally characterized by intense positive feelings and a heightened awareness of self. Time alterations have also been reported. Hyper activation of the anterior insula has been hypothesized as the cause of these experiences. Nausea, irritation of the throat, and an urge to urinate have also been reported as symptoms.<ref name=Hansena/> Some types of these seizures are described with feelings of clarity and certainty, or a complete fixation of the mind on the present moment without escape toward the past or the future, and of absence of any problem, questioning, or doubt.{{MEDRS}}<ref name="pic"/> |
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== Causes and Treatments == |
== Causes and Treatments == |
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People with ecstatic seizures often have a problem with participating in their treatment and also with self-inducing their own pleasurable seizures. They simply want to induce the seizures much as a drug addict wants to continue using drugs even though the harm may be great. Ecstatic seizures have been found to occur with partial seizures as well as grand-Mal seizures. If patients comply with treatment, which is normally drug treatment, it is common to find patients having a significant reduction in symptoms.<ref name= |
People with ecstatic seizures often have a problem with participating in their treatment and also with self-inducing their own pleasurable seizures. They simply want to induce the seizures much as a drug addict wants to continue using drugs even though the harm may be great. Ecstatic seizures have been found to occur with partial seizures as well as grand-Mal seizures. If patients comply with treatment, which is normally drug treatment, it is common to find patients having a significant reduction in symptoms.<ref name=Hansena>{{MEDRS}} {{cite journal|last=Hansena|first=Bjørn|coauthors=Brodtkorb|title=Partial epilepsy with "ecstatic" seizures|journal=Epilepsy & Behavior|year=2003|month=December|volume=4|issue=6|pages=667–673|pmid=14698700}}</ref> |
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Television has been found to induce ecstatic seizures in a small number. Often it is self-induced. Some 150 self inducing patients are described in the literature between 1932 and 1995. To thirds of these patients were females which correlates to the gender ratio for photosensitivity. Many patients don't want to stop watching TV because of the enjoyment it brings them. Photosensitivity is the likely cause of TV induced epilepsy, as some patients are also attractive to florescent lamps and [[venetian blinds]]<ref>{{cite journal|last=Cabrera-Valdivia|first=F.|coauthors=F J Jiménez-Jiménez, J Tejeiro|title=Dostoevsky's epilepsy induced by television|journal=J Neurol Neurosurg Psychiatry|year=1996|volume=61|page=653|doi=10.1136/jnnp.61.6.653}}</ref> |
Television has been found to induce ecstatic seizures in a small number. Often it is self-induced. Some 150 self inducing patients are described in the literature between 1932 and 1995. To thirds of these patients were females which correlates to the gender ratio for photosensitivity. Many patients don't want to stop watching TV because of the enjoyment it brings them. Photosensitivity is the likely cause of TV induced epilepsy, as some patients are also attractive to florescent lamps and [[venetian blinds]].{{MEDRS}}<ref>{{MEDRS}} {{cite journal|last=Cabrera-Valdivia|first=F.|coauthors=F J Jiménez-Jiménez, J Tejeiro|title=Dostoevsky's epilepsy induced by television|journal=J Neurol Neurosurg Psychiatry|year=1996|volume=61|page=653|doi=10.1136/jnnp.61.6.653|pmid=8971121 |pmc=486668 }}</ref> |
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== Dostoyevsky == |
== Dostoyevsky == |
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::"During these moments as raid as lightning, the impression of the life and the consciousness were in himself ten times more intense. His spirit and his heart were illuminated by an immense sense of light; all his emotions and all his doubts, all his anxiety calmed together to be changed into a sovereign serenity made up of lighted joy, harmony, and hope; then, his reason was raised up to the understanding of the final cause." |
::"During these moments as raid as lightning, the impression of the life and the consciousness were in himself ten times more intense. His spirit and his heart were illuminated by an immense sense of light; all his emotions and all his doubts, all his anxiety calmed together to be changed into a sovereign serenity made up of lighted joy, harmony, and hope; then, his reason was raised up to the understanding of the final cause." |
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Dostoevsky saw his ecstatic auras as revelations of an ultimate truth and direct valid knowledge of God. Later in his life is when he developed his levels of creativity, as well as when he began to undergo a change in personality. These changes were evident in his works and were a change from being very rational to becoming a mystic. These personality are known as interictal personality syndrome ([[Geschwind syndrome]]) and were noticed in Dostoevsky by Geschwind himself. Geschwind noticed Dostoevsky's changing personality between his seizures, which is why is is known as interictal. This changes included an increasingly obsessive preoccupation with morality and proper behavior, tendency to become angry easily, lack of humor, and indifference to sexuality. |
Dostoevsky saw his ecstatic auras as revelations of an ultimate truth and direct valid knowledge of God. Later in his life is when he developed his levels of creativity, as well as when he began to undergo a change in personality. These changes were evident in his works and were a change from being very rational to becoming a mystic. These personality are known as interictal personality syndrome ([[Geschwind syndrome]]) and were noticed in Dostoevsky by Geschwind himself. Geschwind noticed Dostoevsky's changing personality between his seizures, which is why is is known as interictal. This changes included an increasingly obsessive preoccupation with morality and proper behavior, tendency to become angry easily, lack of humor, and indifference to sexuality.{{MEDRS}}{{MEDRS|date=November 2013}}{{sfn|Sacks|2012|p=155-158}} |
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== Neural Substrates == |
== Neural Substrates == |
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Ecstatic seizures have been found to occur due to localized abnormalities, as well as epileptiform activity. Common localizations occur in the temporal lobe, and are generally due to partial seizures. Generalized seizures normally include a lack of consciousness so ecstatic seizures are rarely reported.<ref name= |
Ecstatic seizures have been found to occur due to localized abnormalities, as well as epileptiform activity. Common localizations occur in the temporal lobe, and are generally due to partial seizures. Generalized seizures normally include a lack of consciousness so ecstatic seizures are rarely reported.{{MEDRS}}<ref name=Hansena/> The temporal lobe doesn't seem to be the only localization, but the entire temporolimbic system.{{MEDRS}}<ref name="Saver" /> Religious delusion was found to strongly correlate with temporolimbic instability.<ref>{{cite journal |doi=10.1111/j.1399-5618.2009.00737.x |title=The International Society for Bipolar Disorders (ISBD) consensus guidelines for the safety monitoring of bipolar disorder treatments |year=2009 |last1=Ng |first1=Felicity |last2=Mammen |first2=Oommen K |last3=Wilting |first3=Ingeborg |last4=Sachs |first4=Gary S |last5=Ferrier |first5=I Nicol |last6=Cassidy |first6=Frederick |last7=Beaulieu |first7=Serge |last8=Yatham |first8=Lakshmi N |last9=Berk |first9=Michael |journal=Bipolar Disorders |volume=11 |issue=6 |pages=559–95 |pmid=19689501}}</ref> Rarely, pleasurable emotions can be elicited with electrode stimulation of the amygdala, and is associated with hippocampal-septal hypersynchrony. Continuous EEG monitoring during a seizure of effable joy and total bliss revealed right temporolimbic discharge.{{MEDRS}}<ref name="Saver" /> |
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== Relation to Research on the Nature of Self-awareness == |
== Relation to Research on the Nature of Self-awareness == |
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Over the last decade there has been an increasing interest in solving the problem of consciousness through scientific investigation. The main issue is generally thought to be the explanation of how brain processes cause consciousness and how consciousness is realized in the brain. The neural correlates of consciousness can be defined as the minimal set of neuronal events that gives rise to a specific aspect of an experience of [[qualia]]. [[Epilepsy]] is confirmed to represent a privileged window over basic neurobiological mechanisms of consciousness.<ref>{{cite journal|last=Monacoa|first=Francesco|coauthors=Marco Mulaa, Andrea E. Cavanna|title=Consciousness, epilepsy, and emotional qualia|journal=Epilepsy & Behavior|year=2005|month=September|volume=7|issue=2|page=150-160|url=http://www.sciencedirect.com/science/article/pii/S1525505005002106}}</ref> Important Cases of ecstatic epilepsy include those which exhibit intense feelings of [[self-awareness]] or consciousness. Recent research has attempted to label the anterior [[insular cortex]] (AIC) as the "[[neural correlate of consciousness]]", and research on brain activity of ecstatic epileptic patients has supported this theory. The temporal lobe has normally been thought to be behind these seizures but [[neurophysiological]] and neuroradiological evidence has provided a framework for the theory that ecstatic experiences are due to hyper-activation of the anterior insula. Ecstatic seizures have been found to show abnormal activity in anterior temporopolar regions, of which the AIC is physically hidden behind. Symptomatology and functional characteristics of the AIC also suggest that AIC dysfunction could be the cause of ecstatic seizures.<ref name="Picard" /> Although these seizures are suggested to be a product of the AIC, strong arguments are lacking. The insular cortex seems to integrate external sensory and internal physiological signals with computations about their uncertainty, or signalling that we don't understand something. The role played by the AIC in processing uncertainty could be of major importance to account for the “ecstatic” symptom. The role of the AIC in prediction error coding is gaining evidence. Error prediction coding is tracking of how accurate one's forecast was relative to the outcome. Some cases lead to suggestions on the link between ecstatic seizures and the processing or absence of processing of ambiguous information. These observations raise the possible link between prediction error processing and proneness to happiness. |
Over the last decade there has been an increasing interest in solving the problem of consciousness through scientific investigation. The main issue is generally thought to be the explanation of how brain processes cause consciousness and how consciousness is realized in the brain. The neural correlates of consciousness can be defined as the minimal set of neuronal events that gives rise to a specific aspect of an experience of [[qualia]]. [[Epilepsy]] is confirmed to represent a privileged window over basic neurobiological mechanisms of consciousness.<ref>{{cite journal|last=Monacoa|first=Francesco|coauthors=Marco Mulaa, Andrea E. Cavanna|title=Consciousness, epilepsy, and emotional qualia|journal=Epilepsy & Behavior|year=2005|month=September|volume=7|issue=2|page=150-160|url=http://www.sciencedirect.com/science/article/pii/S1525505005002106|pmid=16046279 }}</ref> Important Cases of ecstatic epilepsy include those which exhibit intense feelings of [[self-awareness]] or consciousness. Recent research has attempted to label the anterior [[insular cortex]] (AIC) as the "[[neural correlate of consciousness]]", and research on brain activity of ecstatic epileptic patients has supported this theory. The temporal lobe has normally been thought to be behind these seizures but [[neurophysiological]] and neuroradiological evidence has provided a framework for the theory that ecstatic experiences are due to hyper-activation of the anterior insula. Ecstatic seizures have been found to show abnormal activity in anterior temporopolar regions, of which the AIC is physically hidden behind. Symptomatology and functional characteristics of the AIC also suggest that AIC dysfunction could be the cause of ecstatic seizures.<ref name="Picard" /> Although these seizures are suggested to be a product of the AIC, strong arguments are lacking. The insular cortex seems to integrate external sensory and internal physiological signals with computations about their uncertainty, or signalling that we don't understand something. The role played by the AIC in processing uncertainty could be of major importance to account for the “ecstatic” symptom. The role of the AIC in prediction error coding is gaining evidence. Error prediction coding is tracking of how accurate one's forecast was relative to the outcome. Some cases lead to suggestions on the link between ecstatic seizures and the processing or absence of processing of ambiguous information. These observations raise the possible link between prediction error processing and proneness to happiness.<ref name="pic"> {{MEDRS}} {{cite journal|last=Picard|first=Fabienne|title=State of belief, subjective certainty and bliss as a product of cortical dysfunction|journal=Cortex|year=2013|month=October|volume=49|issue=9|pages=2494–2500|pmid=23415878}}</ref> |
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<ref name="pic">{{cite journal|last=Picard|first=Fabienne|title=State of belief, subjective certainty and bliss as a product of cortical dysfunction|journal=Cortex|year=2013|month=October|volume=49|issue=9|pages=2494–2500}}</ref> |
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==Religious Experience== |
==Religious Experience== |
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Religious experience is brain based. The neural substrates of religious experience and their alterations in brain disorders are of interest to neurologists. Neuroanatomic evidence for these experiences can't be found in animal models and is largely imported from mainly anecdotal epileptic reports. Epilepsy has an ancient link to the divine. Known by the Greeks as the 'sacred disease' and a visitation from the gods. In medieval times seizures were seen as demonic possession. In 1838, heightened religiosity was first scientifically noted in epileptics. A substantial number or major religious founders and leaders were documented or suggested to have epilepsy. |
Religious experience is brain based. The neural substrates of religious experience and their alterations in brain disorders are of interest to neurologists. Neuroanatomic evidence for these experiences can't be found in animal models and is largely imported from mainly anecdotal epileptic reports. Epilepsy has an ancient link to the divine. Known by the Greeks as the 'sacred disease' and a visitation from the gods. In medieval times seizures were seen as demonic possession. In 1838, heightened religiosity was first scientifically noted in epileptics. A substantial number or major religious founders and leaders were documented or suggested to have epilepsy. |
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Religious experiences occur in the [[ictal]], subacute [[postictal]], and chronic [[interictal]] phases of epilepsy. |
Religious experiences occur in the [[ictal]], subacute [[postictal]], and chronic [[interictal]] phases of epilepsy.{{MEDRS}}<ref name ="Saver"/> |
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===Ictal=== |
===Ictal=== |
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[[Ictal]] events are simply the period during a seizure. Ecstatic ictal experiences a sudden and unexpected intrusion into the normal consciousness of an individual. Some psychologists believe religious ictal experiences can be attributed to already religious people perceiving a neutral experience as special. This theory is insufficient to explain these experiences, lacking evidence for distinct emotional states. Although neutral states are not likely to elicit religious emotion, feelings of [[depersonalization]],[[derealization]], and ecstasy may. The phenomenon of [[autoscopy]] may also be affiliated with religious experience. There are two types of autoscopic experience. The first is seeing one's double visualized in external space. The second type is an out of body experience of leaving one's body and viewing it from another perspective. In one series, 6% of epileptic patients experienced this. 88% of them had temporal lobe epilepsy. |
[[Ictal]] events are simply the period during a seizure. Ecstatic ictal experiences a sudden and unexpected intrusion into the normal consciousness of an individual. Some psychologists believe religious ictal experiences can be attributed to already religious people perceiving a neutral experience as special. This theory is insufficient to explain these experiences, lacking evidence for distinct emotional states. Although neutral states are not likely to elicit religious emotion, feelings of [[depersonalization]],[[derealization]], and ecstasy may. The phenomenon of [[autoscopy]] may also be affiliated with religious experience. There are two types of autoscopic experience. The first is seeing one's double visualized in external space. The second type is an out of body experience of leaving one's body and viewing it from another perspective. In one series, 6% of epileptic patients experienced this. 88% of them had temporal lobe epilepsy.{{MEDRS}}<ref name ="Saver"/> |
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===Postictal=== |
===Postictal=== |
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Dramatic and lasting religious conversions have been known to occur in the postictal phase of a seizure, normally following the first few hours or days after seizure activity, which is normally partial seizure activity in the temporal lobe. 23% of epileptic patients with postictal psychosis reported religious content versus 3% of acute interictal psychosis and 0% of chronic interictal psychosis. Some other postictial illusions include [[deja vu]], mental [[diplopia]], and impending [[doom]].<ref name="Saver"/> |
Dramatic and lasting religious conversions have been known to occur in the postictal phase of a seizure, normally following the first few hours or days after seizure activity, which is normally partial seizure activity in the temporal lobe. 23% of epileptic patients with postictal psychosis reported religious content versus 3% of acute interictal psychosis and 0% of chronic interictal psychosis. Some other postictial illusions include [[deja vu]], mental [[diplopia]], and impending [[doom]].{{MEDRS}}<ref name="Saver"/> |
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===Interictal=== |
===Interictal=== |
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The interictal period is that between seizures. Religious preoccupation has been suggested since the 19th century as common feature of interictal activity. Those with Geschwind syndrome, also known as interictal personality disorder, exhibit hyperreligiosity, hypermoralism, humorlessness, [[hypergraphia]], and irritable aggression. Religiosity was found to be significantly higher in those with temporal lobe epilepsy. Interictal spiking and kindling in temporal lobe epileptics has been suggested to lead to intensified sensory-limbic connections. This turns neutral stimuli into a significant affective experience. Heightened meaning and valence would be a natural cause of religiosity. |
The interictal period is that between seizures. Religious preoccupation has been suggested since the 19th century as common feature of interictal activity. Those with Geschwind syndrome, also known as interictal personality disorder, exhibit hyperreligiosity, hypermoralism, humorlessness, [[hypergraphia]], and irritable aggression. Religiosity was found to be significantly higher in those with temporal lobe epilepsy. Interictal spiking and kindling in temporal lobe epileptics has been suggested to lead to intensified sensory-limbic connections. This turns neutral stimuli into a significant affective experience. Heightened meaning and valence would be a natural cause of religiosity.{{MEDRS}}<ref name="Saver" /> |
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== Interesting Accounts == |
== Interesting Accounts == |
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It is not quite known if ecstatic religious experiences happen due to a preexisting religious belief, or whether the brain has particular parts that mediate these feelings. It is probably both as some very skeptical people may find themselves having a religious experience during a seizure. Dewhurst and Beard described a bus driver who had a seizure during his route: |
It is not quite known if ecstatic religious experiences happen due to a preexisting religious belief, or whether the brain has particular parts that mediate these feelings. It is probably both as some very skeptical people may find themselves having a religious experience during a seizure. Dewhurst and Beard described a bus driver who had a seizure during his route: |
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::"He was suddenly overcome with a feeling of bliss. He felt he was literally taken to Heaven. He collected the fares correctly, telling his passengers at the same time how pleased he was to be in Heaven. He remained in this state of exaltation, hearing divine and angelic voices for two days. Afterwards he was able to recall these experiences and he continued to believe in their validity. During the next two years, there was no change in his personality; he did not express and peculiar notions but remained religious. Thre years later, following three seizures on three successive days, he became elated again. He stated that his mind had "cleared". During this episode he lost his faith. |
::"He was suddenly overcome with a feeling of bliss. He felt he was literally taken to Heaven. He collected the fares correctly, telling his passengers at the same time how pleased he was to be in Heaven. He remained in this state of exaltation, hearing divine and angelic voices for two days. Afterwards he was able to recall these experiences and he continued to believe in their validity. During the next two years, there was no change in his personality; he did not express and peculiar notions but remained religious. Thre years later, following three seizures on three successive days, he became elated again. He stated that his mind had "cleared". During this episode he lost his faith. |
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After all of these experiences, this man ceased to believe in heaven or divinity in general. This conversion to athiesm was also ecstatic and revolutionary to him. Ecstatic seizures can lead to Geschwind syndrome and these patients may have multiple ecstatic religious conversions. Geschwind described a girl in her twenties who was on her fifth religion.{{sfn|Sacks|2012|p=158-163}} |
After all of these experiences, this man ceased to believe in heaven or divinity in general. This conversion to athiesm was also ecstatic and revolutionary to him. Ecstatic seizures can lead to Geschwind syndrome and these patients may have multiple ecstatic religious conversions. Geschwind described a girl in her twenties who was on her fifth religion.{{MEDRS|date=November 2013}}{{sfn|Sacks|2012|p=158-163}} |
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== Epidemiology == |
== Epidemiology == |
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Ecstatic seizures occur in only a small number of those who have temporal lobe epilepsy. |
Ecstatic seizures occur in only a small number of those who have temporal lobe epilepsy.{{MEDRS|date=November 2013}}{{sfn|Sacks|2012|p=161}} [[Pleasure]] as an ictal emotion is reported by less than .5% of epileptics. In a 1904 study, 4% of epileptic patients reported a religious aura. Individuals with [[complex partial seizure]]s have a 23% to 83% chance of experiencing [[aura]]s. One quarter of these experiences are considered 'physic'. In one test, 9% of patients with temporal lobe epilepsy had experiences of a loss of reality, of which [[mesolimbic]] structures are evidenced to be responsible.{{MEDRS}}<ref name ="Saver"/> |
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== Implications and Further Research == |
== Implications and Further Research == |
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The sense of the holy is found in nearly every culture across the world. This suggests that there is indeed a biological basis for mystical and religious feelings. Ecstatic seizures suggest a very specific neural basis to religious emotion.{{sfn|Sacks|2012|p=163}} The nural nature and evolutionary purpose of these emotions may help us understand the brain at a deeper level and possibly help reveal the nature of awareness by mechanisms of the Anterior Insular Cortex. |
The sense of the holy is found in nearly every culture across the world. This suggests that there is indeed a biological basis for mystical and religious feelings. Ecstatic seizures suggest a very specific neural basis to religious emotion.{{MEDRS|date=November 2013}}{{sfn|Sacks|2012|p=163}} The nural nature and evolutionary purpose of these emotions may help us understand the brain at a deeper level and possibly help reveal the nature of awareness by mechanisms of the Anterior Insular Cortex.{{cn}} |
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== References == |
== References == |
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'''Footnotes''' |
'''Footnotes''' |
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{{reflist |
{{reflist}} |
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'''Bibliography''' |
'''Bibliography''' |
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{{refbegin|30em}} |
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*{{cite journal|last=Hansena|first=Bjørn|coauthors=H. Lindehammar|authorlink=Bjørn Hansena|title=Insular cortex activation in a patient with "sensed presence"/ecstatic seizures|journal=Epilepsy & Behavior|year=2011|month=April|volume=20|issue=4|pages=714–718}} |
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[[Category:Epilepsy]] |
[[Category:Epilepsy]] |
Revision as of 17:02, 29 November 2013
Ecstatic Seizures, also called Dostoyevsky's Epilepsy, are a type of seizure activity that is characterized by feelings of ecstasy or transcendent joy. Mystical, spiritual, and hallucinatory experiences often occur as well. The temporal lobe is effected by the seizure activity and may provide a neural basis for these experiences, although the exact neural correlates are debated. Ecstatic seizures may be felt as epiphanies or revelations of a deeper reality. Ecstatic Seizures are also called Dostoyevsky's Epilepsy due to the fact that Fyodor Mikhailovich Dostoyevsky, a famous Russian novelist, short story writer, essayist, and philosopher, reported this type of seizure and also made characters in his novels that had a similar condition and experiences as him. Those with temporal lobe epilepsy normally develop Geschwind syndrome, as did Dostoyevsky[unreliable medical source?] [1]
Introduction
The term ecstatic seizure has been applied to two types of experience, often coexisting. The first is simply the experience of deep pleasure or ecstasy. The second type could be described as a pleasurable insight into the unity, harmony, joy, and/or divinity of all reality.[2] The emotion of ecstasy refers to a trance like state of joy. Ecstasy may be considered a heightened sense of awareness and exceptional mental clarity with intense positive feeling. This type of experience can alter many types of perception and sometimes result in a permanent change in the subjective perception of reality. Ecstatic seizures have initially been denied of existence by respected epileptologists, maybe due to its rarity or maybe due to the reluctance or incapability of patients to talk about hallucinations of emotion. These experiences can sometimes be described as 'nonhuman', or just beyond explanation. These circumstances make it hard to document this condition and there is not a significant amount of detailed literature available.[3]
Epilepsy has been associated with religion and mysticism since ancient times, and has been revered or persecuted among cultures.[4] Growing interest in these types of experiences have led to new research and a new field of neurotheology. Ecstatic seizures can generate experiences of religious bliss and sensed presences. They are normally characterized by intense positive feelings and a heightened awareness of self. Time alterations have also been reported. Hyper activation of the anterior insula has been hypothesized as the cause of these experiences. Nausea, irritation of the throat, and an urge to urinate have also been reported as symptoms.[5] Some types of these seizures are described with feelings of clarity and certainty, or a complete fixation of the mind on the present moment without escape toward the past or the future, and of absence of any problem, questioning, or doubt.[unreliable medical source?][6]
Causes and Treatments
People with ecstatic seizures often have a problem with participating in their treatment and also with self-inducing their own pleasurable seizures. They simply want to induce the seizures much as a drug addict wants to continue using drugs even though the harm may be great. Ecstatic seizures have been found to occur with partial seizures as well as grand-Mal seizures. If patients comply with treatment, which is normally drug treatment, it is common to find patients having a significant reduction in symptoms.[5]
Television has been found to induce ecstatic seizures in a small number. Often it is self-induced. Some 150 self inducing patients are described in the literature between 1932 and 1995. To thirds of these patients were females which correlates to the gender ratio for photosensitivity. Many patients don't want to stop watching TV because of the enjoyment it brings them. Photosensitivity is the likely cause of TV induced epilepsy, as some patients are also attractive to florescent lamps and venetian blinds.[unreliable medical source?][7]
Dostoyevsky
Fyodor Dostoevsky first created the concept of ecstatic seizures with his own descriptions of seizures he was having, and ecstatic epilepsy is frequently referred to as Dostoevsky's epilepsy. As late as 1978, Dostoevsky's epilepsy existence was rejected due to its rarity. It was believed that Dostoevsky's creativity led him to embellish his accounts on his seizures. He described his seizures as having an enhanced well being and awareness, as well as a feeling of, "perfect harmony with himself and the entire universe". He also describes a sense of time dilation, even saying he could not tell if his seizure has been lasting for months.[3]
Dostoevsky first began to have seizures as a child, but became frequent in his forties when he came back from Siberia where he was exiled for being a liberal utopian. It was in Siberia he was first diagnosed with epilepsy. His grandmal seizures were preceded by a mystical or ecstatic aura and sometimes would not lead to a full seizure. His first seizure happened when he was talking about religion with is friend and it became midnight. He suddlenly decalred, "God exists, He exists!" His full description is as follow:
- "The air was filled with a big noise and I tried to move. I felt the heaven was going down upon the earth and that it had engulfed me. I have really touched God. He came into me myself, yes all, healthy people, he said, can't imagine the happiness which we epileptics feel during the second or so before our fit.. I don't know if this felicity lasts for seconds, hours or months, but believe me, for all the joys that life may bring, I would not exchange this one."
He was a very creative writer and his works often reflected his own life. He gave his characters seizures like his own and one character's seizures he describes in his book, The Idiot:
- "During these moments as raid as lightning, the impression of the life and the consciousness were in himself ten times more intense. His spirit and his heart were illuminated by an immense sense of light; all his emotions and all his doubts, all his anxiety calmed together to be changed into a sovereign serenity made up of lighted joy, harmony, and hope; then, his reason was raised up to the understanding of the final cause."
Dostoevsky saw his ecstatic auras as revelations of an ultimate truth and direct valid knowledge of God. Later in his life is when he developed his levels of creativity, as well as when he began to undergo a change in personality. These changes were evident in his works and were a change from being very rational to becoming a mystic. These personality are known as interictal personality syndrome (Geschwind syndrome) and were noticed in Dostoevsky by Geschwind himself. Geschwind noticed Dostoevsky's changing personality between his seizures, which is why is is known as interictal. This changes included an increasingly obsessive preoccupation with morality and proper behavior, tendency to become angry easily, lack of humor, and indifference to sexuality.[unreliable medical source?][unreliable medical source?][1]
Neural Substrates
Ecstatic seizures have been found to occur due to localized abnormalities, as well as epileptiform activity. Common localizations occur in the temporal lobe, and are generally due to partial seizures. Generalized seizures normally include a lack of consciousness so ecstatic seizures are rarely reported.[unreliable medical source?][5] The temporal lobe doesn't seem to be the only localization, but the entire temporolimbic system.[unreliable medical source?][2] Religious delusion was found to strongly correlate with temporolimbic instability.[8] Rarely, pleasurable emotions can be elicited with electrode stimulation of the amygdala, and is associated with hippocampal-septal hypersynchrony. Continuous EEG monitoring during a seizure of effable joy and total bliss revealed right temporolimbic discharge.[unreliable medical source?][2]
Relation to Research on the Nature of Self-awareness
Over the last decade there has been an increasing interest in solving the problem of consciousness through scientific investigation. The main issue is generally thought to be the explanation of how brain processes cause consciousness and how consciousness is realized in the brain. The neural correlates of consciousness can be defined as the minimal set of neuronal events that gives rise to a specific aspect of an experience of qualia. Epilepsy is confirmed to represent a privileged window over basic neurobiological mechanisms of consciousness.[9] Important Cases of ecstatic epilepsy include those which exhibit intense feelings of self-awareness or consciousness. Recent research has attempted to label the anterior insular cortex (AIC) as the "neural correlate of consciousness", and research on brain activity of ecstatic epileptic patients has supported this theory. The temporal lobe has normally been thought to be behind these seizures but neurophysiological and neuroradiological evidence has provided a framework for the theory that ecstatic experiences are due to hyper-activation of the anterior insula. Ecstatic seizures have been found to show abnormal activity in anterior temporopolar regions, of which the AIC is physically hidden behind. Symptomatology and functional characteristics of the AIC also suggest that AIC dysfunction could be the cause of ecstatic seizures.[3] Although these seizures are suggested to be a product of the AIC, strong arguments are lacking. The insular cortex seems to integrate external sensory and internal physiological signals with computations about their uncertainty, or signalling that we don't understand something. The role played by the AIC in processing uncertainty could be of major importance to account for the “ecstatic” symptom. The role of the AIC in prediction error coding is gaining evidence. Error prediction coding is tracking of how accurate one's forecast was relative to the outcome. Some cases lead to suggestions on the link between ecstatic seizures and the processing or absence of processing of ambiguous information. These observations raise the possible link between prediction error processing and proneness to happiness.[6]
Religious Experience
Religious experience is brain based. The neural substrates of religious experience and their alterations in brain disorders are of interest to neurologists. Neuroanatomic evidence for these experiences can't be found in animal models and is largely imported from mainly anecdotal epileptic reports. Epilepsy has an ancient link to the divine. Known by the Greeks as the 'sacred disease' and a visitation from the gods. In medieval times seizures were seen as demonic possession. In 1838, heightened religiosity was first scientifically noted in epileptics. A substantial number or major religious founders and leaders were documented or suggested to have epilepsy. Religious experiences occur in the ictal, subacute postictal, and chronic interictal phases of epilepsy.[unreliable medical source?][2]
Ictal
Ictal events are simply the period during a seizure. Ecstatic ictal experiences a sudden and unexpected intrusion into the normal consciousness of an individual. Some psychologists believe religious ictal experiences can be attributed to already religious people perceiving a neutral experience as special. This theory is insufficient to explain these experiences, lacking evidence for distinct emotional states. Although neutral states are not likely to elicit religious emotion, feelings of depersonalization,derealization, and ecstasy may. The phenomenon of autoscopy may also be affiliated with religious experience. There are two types of autoscopic experience. The first is seeing one's double visualized in external space. The second type is an out of body experience of leaving one's body and viewing it from another perspective. In one series, 6% of epileptic patients experienced this. 88% of them had temporal lobe epilepsy.[unreliable medical source?][2]
Postictal
Dramatic and lasting religious conversions have been known to occur in the postictal phase of a seizure, normally following the first few hours or days after seizure activity, which is normally partial seizure activity in the temporal lobe. 23% of epileptic patients with postictal psychosis reported religious content versus 3% of acute interictal psychosis and 0% of chronic interictal psychosis. Some other postictial illusions include deja vu, mental diplopia, and impending doom.[unreliable medical source?][2]
Interictal
The interictal period is that between seizures. Religious preoccupation has been suggested since the 19th century as common feature of interictal activity. Those with Geschwind syndrome, also known as interictal personality disorder, exhibit hyperreligiosity, hypermoralism, humorlessness, hypergraphia, and irritable aggression. Religiosity was found to be significantly higher in those with temporal lobe epilepsy. Interictal spiking and kindling in temporal lobe epileptics has been suggested to lead to intensified sensory-limbic connections. This turns neutral stimuli into a significant affective experience. Heightened meaning and valence would be a natural cause of religiosity.[unreliable medical source?][2]
Interesting Accounts
Many of those who experience ecstatic seizures are profoundly moved by them and may try to induce them regularly. Some patients who have never had any interest in religion may suddenly become hyper-religious as a result of these seizures. One such patient described by Orrin Devinsky (temporal lobe epileptologist) began to seize and became pale and unresponsive. After a short period of this, began to run around in circles yelling, "I am free, I am free... I am Jesus! I am Jesus!". The patient had another seizure recorded on EEG in which he seemed disoriented. When asked if something was wrong he replied, "Nothing is wrong. I am doing well, I am very Happy", and when asked if he knew where he was he smiled and with a surprised look responded, "Of course I know. I am in Heaven right now. I am fine". This aspect of the seizure lasted for ten minutes, then a full generalized seizure occurred. He did remember the gist of the experience as a vivid happy dream, but not the researchers. Another woman who suffered a head injury began to experience Déjà vu and kept smelling strange smells. Both of these symptoms are common in partial seizures. After a cluster of these seizures, the woman entered an exalted state of God, and an angel told her to run for congress which she then did, believing what she experienced. She ran as a republican in a long run democratic district and barely lost. She told people that god told her to run which got her thousands of votes despite her lack of political skills.
These seizures can be dangerous. It is known that epileptics can become aggressive during a seizure, but without any directed violence. Unfortunately, ecstatic seizures add a new element to epileptic aggression. Another patient described by Devinsky had a seizure induced vision that Christ was commanding him to kill his wife and then himself. He killed his wife and stabbed himself, but he lived. He had a seizure focus in his right temporal lobe and after it was removed he ceased to have and more seizure visions and returned to normal behavior. This is similar to the command hallucinations of psychosis and can be hard to discredit as not part of reality.
Joan of Arc is an interesting case of possible ecstatic epilepsy. How could a farmer's daughter with no formal education behave found so much drive and passion in getting thousands to help drive the English out of France? It is known that Joan of Arc experienced visions and voices since the age of thirteen. She was originally afraid but began to get a sense of mission from these visions. One description be here is as follows:
- "I was thirteen when I had a voice from God for my help and guidance. The first time that I heard this voice, I was very much frightened; it was midday, in the summer, in my father's garden... I heard this voice to my right, towards the church; rarely do I hear it without its being accompanied also by light. This light comes from the same side as the Voice. Generally it is a great light... When I heard it for the first time, I recognized that it was the voice of an angel. This voice has always guarded me well, and I have always understood it; it instructed me to be good and go often to church; it told me it was necessary to come into France. It said to me two or three times a week: "you must go into France." ... It said to me: "Go, raise the siege which is being made before the city of New Orleans. Go!"...and I replied that I was but a poor girl, who knew nothing of riding or fighting... There is never a day when I do not hear this voice; and I have much need of it"
It is not quite known if ecstatic religious experiences happen due to a preexisting religious belief, or whether the brain has particular parts that mediate these feelings. It is probably both as some very skeptical people may find themselves having a religious experience during a seizure. Dewhurst and Beard described a bus driver who had a seizure during his route:
- "He was suddenly overcome with a feeling of bliss. He felt he was literally taken to Heaven. He collected the fares correctly, telling his passengers at the same time how pleased he was to be in Heaven. He remained in this state of exaltation, hearing divine and angelic voices for two days. Afterwards he was able to recall these experiences and he continued to believe in their validity. During the next two years, there was no change in his personality; he did not express and peculiar notions but remained religious. Thre years later, following three seizures on three successive days, he became elated again. He stated that his mind had "cleared". During this episode he lost his faith.
After all of these experiences, this man ceased to believe in heaven or divinity in general. This conversion to athiesm was also ecstatic and revolutionary to him. Ecstatic seizures can lead to Geschwind syndrome and these patients may have multiple ecstatic religious conversions. Geschwind described a girl in her twenties who was on her fifth religion.[unreliable medical source?][10]
Epidemiology
Ecstatic seizures occur in only a small number of those who have temporal lobe epilepsy.[unreliable medical source?][11] Pleasure as an ictal emotion is reported by less than .5% of epileptics. In a 1904 study, 4% of epileptic patients reported a religious aura. Individuals with complex partial seizures have a 23% to 83% chance of experiencing auras. One quarter of these experiences are considered 'physic'. In one test, 9% of patients with temporal lobe epilepsy had experiences of a loss of reality, of which mesolimbic structures are evidenced to be responsible.[unreliable medical source?][2]
Implications and Further Research
The sense of the holy is found in nearly every culture across the world. This suggests that there is indeed a biological basis for mystical and religious feelings. Ecstatic seizures suggest a very specific neural basis to religious emotion.[unreliable medical source?][12] The nural nature and evolutionary purpose of these emotions may help us understand the brain at a deeper level and possibly help reveal the nature of awareness by mechanisms of the Anterior Insular Cortex.[citation needed]
References
Footnotes
- ^ a b Sacks 2012, p. 155-158.
- ^ a b c d e f g h [unreliable medical source?] Saver, J., L. (1997). "The neural substrates of religious experience". J Neuropsychiatry Clin Neurosci. Summer. 9 (3): 498-510. PMID 9276850.
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suggested) (help)CS1 maint: multiple names: authors list (link) See followup comment at PubMed, "religious experience was not correctly defined" - ^ a b c Picard, F (2009). "Ecstatic Epileptic Seizures: A Potential Window for the Neural Basis of Human Self-Awareness". Epilepsy & Behavior. 16: 539–546. PMID 19836310.
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ignored (help) - ^ Devinsky, Orrin (2008). "Spirituality and Religion in Epilepsy". Epilepsy & Behavior. 12 (4): 636–643. PMID 18171635.
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suggested) (help); Unknown parameter|month=
ignored (help) - ^ a b c [unreliable medical source?] Hansena, Bjørn (2003). "Partial epilepsy with "ecstatic" seizures". Epilepsy & Behavior. 4 (6): 667–673. PMID 14698700.
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suggested) (help); Unknown parameter|month=
ignored (help) - ^ a b [unreliable medical source?] Picard, Fabienne (2013). "State of belief, subjective certainty and bliss as a product of cortical dysfunction". Cortex. 49 (9): 2494–2500. PMID 23415878.
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ignored (help) - ^ [unreliable medical source?] Cabrera-Valdivia, F. (1996). "Dostoevsky's epilepsy induced by television". J Neurol Neurosurg Psychiatry. 61: 653. doi:10.1136/jnnp.61.6.653. PMC 486668. PMID 8971121.
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suggested) (help) - ^ Ng, Felicity; Mammen, Oommen K; Wilting, Ingeborg; Sachs, Gary S; Ferrier, I Nicol; Cassidy, Frederick; Beaulieu, Serge; Yatham, Lakshmi N; Berk, Michael (2009). "The International Society for Bipolar Disorders (ISBD) consensus guidelines for the safety monitoring of bipolar disorder treatments". Bipolar Disorders. 11 (6): 559–95. doi:10.1111/j.1399-5618.2009.00737.x. PMID 19689501.
- ^ Monacoa, Francesco (2005). "Consciousness, epilepsy, and emotional qualia". Epilepsy & Behavior. 7 (2): 150-160. PMID 16046279.
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ignored (help) - ^ Sacks 2012, p. 158-163.
- ^ Sacks 2012, p. 161.
- ^ Sacks 2012, p. 163.
Bibliography
- [unreliable medical source?] Sacks, Oliver (2012). Hallucinations. Knopf. pp. 155–163.
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