On one occasion, when Valerie was in college, she felt weak and not quite herself, so she went to her parents’ house for the evening. She and her mother were sitting and talking as Valerie lay in bed, when she suddenly “saw” e-mails she had received earlier in the day plastered all over her bedroom. One particular e-mail was multiplied, and one of its images was superimposed on her mother’s face, although she could see the face through it. The image of the e-mail was so clear and exact that she could read every word. Objects from her dorm room appeared everywhere she looked. It was a particular object, whether perceived or remembered, that got multiplied, never a whole scene. Her visual multiplications and reiterations are now of familiar faces for the most part, “projected” onto the walls, the ceiling, any available surface. This sort of spreading of visual perceptions in space (polyopia) and in time (palinopsia) was vividly described by Macdonald Critchley, who first used the term palinopsia (he originally called it paliopsia).
Valerie may also experience perceptual changes in relation to her seizures; indeed, her first intimation of a seizure is sometimes that her own reflection looks different—her eyes, in particular. She may feel, “This is not me,” or “It’s a close relative.” If she can go to sleep, she can avert a seizure. But if she has not been able to sleep well, other people’s faces may also look different the next morning—“strange” and distorted, especially around the eyes, though not so much that they are unrecognizable. Between attacks, she may have the opposite feeling—a hyperfamiliarity, so that everyone seems familiar to her. It is a feeling so overwhelming that sometimes she cannot resist greeting a stranger, even though, intellectually, she can say to herself, “This is just an illusion. It seems most unlikely that I have ever met this person.”
Despite her epileptic auras, Valerie lives a full and productive life, keeping up with a demanding career. She is reassured by three things: that she has not had a generalized seizure for ten years, that whatever is provoking her attacks is not progressive (she had a minor head injury when she was twelve and probably has a small temporal lobe scar from that injury), and that medication can provide adequate control.
Both Jen and Valerie were initially misdiagnosed as having“migraine”—such confusion of epilepsy and migraine
is not uncommon. Gowers was at pains to differentiate them in his 1907 book,
Laura M., a psychology major in college, at first ignored her “strange attacks” but finally consulted an epilepsy specialist, who found that she was “experiencing stereotypic episodes of déjà vu, visual and emotional flashbacks of a dream or series of dreams, usually one of five dreams . . . which she had in the past ten years.” These could happen several times daily and were aggravated by tiredness or by marijuana. When she started taking an antiepileptic medication, her attacks decreased in severity and frequency, but she had increasingly unacceptable side effects—in particular, a feeling of overstimulation followed by a “crash” later in the day. She took herself off the medication and reduced her use of marijuana, and now her attacks are at a tolerable level, perhaps half a dozen per month. They last only a few seconds, and although the internal feeling is overwhelming and she may “zone out” a little, others might not notice anything amiss. The only physical symptom she feels during these attacks is an impulse to roll her eyeballs back, which she resists when others are around.
When I met Laura, she said she had always had vivid, richly colored dreams that she could easily remember, and she characterized most of them as “geographic,” involving complex landscapes. She felt that the visual hallucinations or flashbacks she had in her seizures all drew on the landscapes of those dreams.
