Ictal autoscopic phenomena and near death experiences: a study of five patients with ictal autoscopies

Abstract

Autoscopic phenomena in general may-among other conditions-occur during epileptic seizures and near death experiences. We set the hypothesis that ictal autoscopic phenomena and near death experiences have a similar semiology as measured by the Near Death Experience Questionnaire. We also investigated whether patients with aura before temporal lobe seizures with or without autoscopic phenomena could be distinguished by this questionnaire. For these purposes, we examined five patients with ictal autoscopy and 12 patients with aura before temporal lobe seizures without ictal autoscopy as controls. We used a cut-off of 7 points or higher on the Near Death Experience Questionnaire for indicating the semiology of a near death experience and for distinguishing patients with ictal autoscopy from controls. This cut-off separated patients with ictal autoscopic phenomena from aura before temporal lobe seizures without autoscopy (p = 0.0002, two-sided, exact Fisher's Test; specificity: 100 % [CI95 % 77.9 and 100 %], sensitivity: 100 % [CI95 % 54.9 and 100 %]). Furthermore, all autoscopic patients (range 7-10) and none of the controls (range 0-5) had scores of 7 points or higher. Thus, the individual experiences during simple partial autoscopic seizures and near death experiences are similar, at least in some prominent aspects. These findings might be of particular interest for the pathophysiology of near death experiences, as all patients with ictal autoscopic phenomena had an epileptic dysfunction at the temporo-parietal junction or its neighboring regions. Therefore, a malfunction of this brain region might also be involved in near death experiences of other origins especially during states which could cause a near death experience and a cerebral excitability.

Temporality of Features in Near-Death Experience Narratives

“…Neurobiological theories have notably proposed the potential implications of REM-sleep intrusions (Nelson et al, 2006), pharmacological factors (Jansen, 1989), altered blood gas levels (Klemenc-Ketis et al, 2010) as well as paroxistic temporal lobe disorders (Blanke et al, 2004; Britton and Bootzin, 2004; Hoepner et al, 2013). While sustained efforts have been made to better understand certain phenomenological features encountered during NDEs, the scientific literature devoted to the investigation of temporal structure of NDEs narratives seems rather limited.…”

Near-death experiences in non-life-threatening events and coma of different etiologies

“…Only a few studies have assessed “NDE-like” phenomena in non-life threatening situations (Gabbard et al, 1981; Owens et al, 1990; Gabbard and Twemlow, 1991; Kelly, 2001; Facco and Agrillo, 2012). Such accounts have also been reported in epileptic patients (Hoepner et al, 2013), syncope (Lempert et al, 1994), intense grief and anxiety (Kelly, 2001), Cotard's syndrome (McKay and Cipolotti, 2007; Charland-Verville et al, 2013) and during meditative state (Beauregard et al, 2009). It remains unclear whether NDEs occurring in life-threatening or non-life threatening situations differ in intensity or core features.…”

“…However, our findings on differences between retrospective and prospective post-anoxic NDE reports seem to be confirmed when extended to other etiologies as illustrated in Figure 1. A visual comparison of the weighted ratios of core NDE features calculated from four retrospective studies (Greyson, 1990; Nelson et al, 2006; Lai et al, 2007) (total n = 429; including the present dataset) and four prospective studies (Parnia et al, 2001; Schwaninger et al, 2002; Greyson, 2003a; Hoepner et al, 2013) (total n = 47), all using the Greyson NDE scale, illustrates that all items (with the exception of encounters with deceased or spirits) seem more frequently reported retrospectively.…”

“…The Greyson NDE scale is a widely used and validated tool to assess the intensity and content of NDEs (Greyson, 1990, 2003a,b; Parnia et al, 2001; Schwaninger et al, 2002; Nelson et al, 2006; Lai et al, 2007; Klemenc-Ketis et al, 2010; Hoepner et al, 2013; Hou et al, 2013) and, in contrast to the Weighted Core Experience Index (WCEI; Ring, 1980), provides a cut-off score permitting a standardized identification of NDE experiencers (NDErs). As for other retrospective studies on NDEs (Greyson, 1990; Lai et al, 2007), the interval between the age at study enrollment (mean age 56 ± 13 year) and the occurrence of the NDE (mean age 32 ± 15 year) was several decades (mean 24 ± 15 year).…”

“…Some authors have tried to explain the phenomenology of NDE by diverse physiological explanations such as anoxic brain damage (Rodin, 1980; Blackmore, 1993; Greyson, 1998; Els et al, 2004; Woerlee, 2005; Ammermann et al, 2007), hypoxia (Lempert et al, 1994), hypercapnia (Klemenc-Ketis et al, 2010), abnormal temporal lobe dysfunctions (Blanke et al, 2002, 2004; Britton and Bootzin, 2004; Blanke and Mohr, 2005; Arzy et al, 2006; Hoepner et al, 2013), administration of sedatives (Cobcroft and Forsdick, 1993; Osterman et al, 2001; Lopez et al, 2006), or sleep abnormalities (Nelson et al, 2006, 2007). However, to the best of our knowledge, previous studies on NDE after coma have not aimed at identifying differences in NDE characteristics depending on the etiology (i.e., traumatic, non-traumatic anoxic or non-traumatic other acute brain insults) of the prolonged loss of consciousness.…”