Ecstatic epileptic seizures: a potential window on the neural basis for human self-awareness

Epileptic feeling of multiple presences in the frontal space

We describe the case of a patient who during a simple focal epileptic seizure due to vascular cerebral sequelae, reported the paroxysmal convincing feeling of the presence of several familiar persons in her peripersonal and extrapersonal space. Because the patient reported sensing multiple presences and recognizing them as family members, her case appears to contradict the hypothesis that the feeling of a non-existent human presence is an autoscopic phenomenon involving the neural "reduplication of the body". As an alternative hypothesis, I propose that the feeling of a non-existent presence may be only a hallucination of an ordinary "perception of the presence of another". Otherwise, the closest presence was felt in front of the patient, without lateralization in one hemispace, suggesting the importance to take into account other spatial dimensions than the left/right dimension, such as the front/back dimension, in the feeling of a presence. Illusory perceptive phenomena could participate in future in better understanding brain regions involved in the front/back dimension of the space perceptive representation.