Epilepsy and Ecstatic Experiences: The Role of the Insula.

Ecstatic epilepsy is a rare form of focal epilepsy where the seizure aura is a blissful state of mental clarity and certainty, often described as religious or mystical. Over the last decade, evidence has located the symptomatogenic zone for this experience in the dorsal anterior insula. The neurocognitive hypothesis proposes that the feeling of mental clarity arises from suppression of interoceptive prediction errors and unexpected surprise from internal or external signals, which are normally processed by the dorsal anterior insula. This mimics a perfect prediction of the world, inducing certainty. Ecstatic epilepsy thus serves as a model for the anterior insula's role in uncertainty and surprise.

Study at a glance

Abstract

Ecstatic epilepsy is a rare form of focal epilepsy in which the aura (beginning of the seizures) consists of a blissful state of mental clarity/feeling of certainty. Such a state has also been described as a "religious" or mystical experience. While this form of epilepsy has long been recognized as a temporal lobe epilepsy, we have accumulated evidence converging toward the location of the symptomatogenic zone in the dorsal anterior insula during the 10 last years. The neurocognitive hypothesis for the genesis of a mental clarity is the suppression of the interoceptive prediction errors and of the unexpected surprise associated with any incoming internal or external signal, usually processed by the dorsal anterior insula. This mimics a perfect prediction of the world and induces a feeling of certainty. The ecstatic epilepsy is thus an amazing model for the role of anterior insula in uncertainty and surprise.