Epilepsiu. zyxwvutsrqponmlkjihgf 40(2).239-241, 1999 Lippincott Williams zyxwvutsrqponmlkji Kr Wilkin\, Inc., Philadelphia zyxwvutsrqp 0 International League Against Epilep~y Brief Communication Epilepsy and Religious Experiences: Voodoo Possession E. Carrazana, J. DeToledo, W. Tatum, R. Rivas-Vasquez, G. Rey, and zyx S. Wheeler Neurologic zyxwvutsrqpon Cenenter zyxwvutsrqp o;f South Florida, University zyxwvutsr of Miami School of Medicine, and University oj South Floi-idu-Tampa General HoJpitul, Miami, Floridu, U.S.A. Summary: Epileptic seizures have a historical association with religion, primarily through the concept of spirit posses- sion. Five cases where epileptic seizures were initially attrib- uted to Voodoo spirit possession are presented. The attribution is discussed within the context of the Voodoo belief system. Key Words: Epilepsy-Seizures-Religion-Voodoo- Possessions. The concept of possession, “to be seized by spirits,” is central to the historic association of religion and the epilepsies. A common belief of ancient cultures was that mental disturbances were caused by supernatural inter- ference. The early Greeks viewed epilepsy as a visitation from the gods, and thus a sacred disease. Christians dur- ing medieval times followed the biblical belief of de- monic possessions (Matthew 17: 14-1 8). Persons with epilepsy themselves have often explained their seizures as religious experiences, particularly the feelings associ- ated with depersonalization, derealization, and autoscopy of temporal lobe epilepsy. Furthermore, most of the re- ports invoke elements of Christianity, thereby reflecting a Eurocentric view of the subject (1). Voodoo is the most popular religion in Haiti. It has preserved many of the characteristics of the Dahomean and Guinean cults from which it derives (2). Worship and possessions by spirits (loas) are the essence of Voo- doo; thus many illnesses are explained on that basis. Spirits incarnate themselves at will in the people they choose. The person possessed is a mere receptacle bor- rowed by the spirit for the purpose of revealing itself. In that sense, the experience is similar to an epileptic sei- zure in that the patient has no control over its timing nor expression. Voodoo faithfuls voluntarily place them- selves under the authority of some priest/priestess (hun- gun, mambo), with the interpretation of beliefs depend- ing on a great extent on their influence (3). We report a Accepted July 17, 1998. Address correspondence and reprint requests to Dr. E. J. Carrazana at Neurologic Center of South Florida, Baptist Hospital Outpatient Bldg., 802-E, 8940 N. Kendall Drive, Miami, FL 33176, U.S.A. series of patients with epilepsy whose seizures were at- tributed to possession by Voodoo spirits. These cases demonstrate that beliefs and folklore are not always harmless in that, at times, they can adversely affect clini- cal management. In addition to being a source of great anxiety, they may delay appropriate diagnosis and treat- ment. CASES Case 1 This 24-year-old Haitian man had his first generalized tonic-clonic seizure at the age of 17 years during the wake of an uncle. The patient had been sleep deprived during the vigil of the corpse. The seizure was attributed to possession by Ogu (the warrior god), the dead uncle’s protecting loa. Subsequent seizures and morning myoc- lonus were explained as harassment by the wandering soul of the uncle. The possession was interpreted as a punishment, for the patient had been disrespectful toward the deceased in the past. He was treated by the local mambo (priest) for 6 years and did not see a physician until coming to the United States. His EEG showed 3- to 4-Hz bursts of generalized spike-wave complex dis- charges occurring spontaneously and during photic stimulation. In retrospect, the patient had a history of waking myoclonus, which had been ignored. He re- mained seizure free after treatment with valproic acid (VPA). The likely diagnosis is juvenile myoclonic epi- lepsy. Case 2 This 27-year-old Haitian woman, with a history of complex partial and secondarily generalized seizures 239