Ten patients with seizures and autoscopic phenomena, such as seeing one’s double, are reported and 33 additional cases in the literature are reviewed from the Medical Neurology Branch, Division of Intramural Research, National Institute of Neurological Disorders and Stroke, Bethesda, MD; and the Department of Neurology, New York Hospital, New York, NY. The ictal autoscopy began at a median age of 25 years (range, 8 to 62 years), and the mean age at the time of case reporting was 34 years (range, 13 to 73 years). Autoscopic phenomena occurred as symptoms of simple partial, complex partial, or generalized tonic-clonic seizures. Out-of-body experiences occurred in five patients who gave vivid descriptions of the seizures and a feeling of leaving one’s body and viewing it from another vantage point, usually from above. One patient stated “I watched the whole episode as if I were at the movies“. She felt herself “slip back into my body“. The temporal lobe was involved in 18 (86%) of the 21 patients in whom the seizure focus could be identified. There was no clear lateralization of lesions. The response of autoscopic episodes to treatment usually paralleled that of the underlying seizure disorder. [1]
COMMENT. The authors comment that autoscopic phenomena are likely to be discovered only on specific questioning of patients with epilepsy and may be an important and distressing feature of a chronic seizure disorder. Fear is a common symptom of complex partial seizures in children and may be explained by autoscopic phenomena. Autoscopy, the hallucination or psychic experience of seeing oneself, may also occur in healthy persons in association with anxiety and fatigue. It is reported frequently in near death encounters such as drowning and automobile accidents.