I expect to smell something at any moment, but I don’t yet. . . . The first time it ever happened, I was out in the country and I was feeling funny. I was in a field picking forget-me-nots. I remember very well that I kept smelling these flowers even though I knew they had no odour. For about half an hour I kept sniffing them because I was sure they would begin to smell soon. . . even though I knew perfectly well at that time that forget-me-nots have no odour at all. . . . I know it and don’t know it at the same time.
In this second phase of her epileptic aura, Mrs. B. continued to feel more and more “remote,” until finally she knew a convulsion was near. She would lie on the floor, away from the furniture, to avoid hurting herself during the convulsion. Then, she said:
Just when I seem to be as remote as I possibly could get, I suddenly get a smell like an explosion or a crash. There is no buildup. It is all there at once. At the same moment that the smell crashes through, I’m back in the real world—I no longer feel remote. The smell is a disgusting sweet, penetrating odour like very cheap perfume. . . . Everything seems very quiet. I don’t know if I can hear. I am all alone with the smell.
The smell would last for a few seconds and then go away, though the silence remained for five or ten seconds, until she heard a voice off to her right calling her name. She said:
This is not like hearing a voice in a dream. It is a
She would try hard not to turn towards the voice, but it was irresistible. Finally, she would lose consciousness and have a convulsion.
Gowers had a “favorite” seizure, one that he returned to in his writing many times, for this patient, like Thelma B., had an epileptic aura that involved many
different sorts of hallucinations, unfolding in a “march” or stereotyped progression of symptoms. This showed Gowers how an epileptic excitation might move about the brain, stimulating
first one part, then another, and evoking corresponding hallucinations as it did so. He first described this patient in his 1881 book
The patient was an intelligent man, twenty-six years of age, and all his attacks began in the same manner. First there was a sensation [under the ribs, on the left side] “like pain with a cramp;” then, this sensation continuing, a kind of lump seemed to pass up the left side of the chest, with a “thump, thump,” and when it reached the upper part of the chest it became a “knocking,” which was heard as well as felt. The sensation rose up to the left ear, and then was like the “hissing of a railway engine,” and this seemed to “work over his head.” Then he suddenly and invariably saw before him an old woman in a brown-stuff dress, who offered him something which had the smell of Tonquin beans. The old woman then disappeared, and two great lights came before him—round lights, side by side, which got nearer and nearer with a jerking motion. When the lights appeared the hissing noise ceased, and he felt a choking sensation in the throat, and lost consciousness in the fit, which, from the description, was undoubtedly epileptic.
For most people, focal seizures always consist of the same symptoms repeated with little or no variation, but others may have a large repertoire of auras. Amy Tan, the novelist, whose epilepsy may have been caused by Lyme disease, described her hallucinations to me.
“When I realized the hallucinations were seizures,” she said, “I found them fascinating as brain quirks. I tried to notice the details of the ones that repeated.” And, being a writer, she gave all of her repeating hallucinations names. The most frequent one she calls the “Illuminated Spinning Odometer.” She describes it as
what you might see on the dash of your car at night . . . except the numbers begin spinning more and more rapidly, like a gas pump giving you a running tally of the cost of gas. After about twenty seconds, the numbers begin to disintegrate and the odometer itself falls apart, and gradually disappears. Because it happened so often . . . I made it a game to see if I could name the numbers as they were falling, or to see if I could control the speed of the odometer or make the hallucination last longer. I could not.
None of her other hallucinations moved. For a time, she would often see
