Positive autoscopic phenomena such as autoscopy, heautoscopy, and out-of-body experiences occur in various diseases and in healthy individuals but are underreported in focal epilepsies. In a group of 14 patients with ictal lateralized autoscopic phenomena, 12 (85.7%) had an epileptic focus on the opposite side of the brain from where the autoscopic image appeared. This suggests that when a person with epilepsy sees a double or an image of themselves to one side during a seizure, the seizure focus is likely in the opposite brain hemisphere.
A 48-year-old man experienced repeated episodes combining out-of-body experiences, visual hallucinations, and auditory hallucinations. These events were ultimately diagnosed as cardiogenic syncope after a subcutaneous event recorder was implanted. The symptoms stopped completely after a cardiac pacemaker was implanted. The report emphasizes that the event recorder was essential for making the correct diagnosis and that the cessation of symptoms after pacemaker implantation confirmed it.