St Theresa's dart and a case of religious ecstatic epilepsy

Abstract

Objective: : We report a case of ecstatic seizures with religious overtones in a patient whose semiology resembles that of Saint Theresa of Avila (1515 to 1582), and review the anatomical basis of this phenomenon.

Background: : Seizures with an emotional component are typically associated with negative sensations. Ecstatic seizures, particularly those with a religious character, are rarely reported, although they hold an important place in history, as a number of religious figures have been posited to be epileptic. Here, we present a patient with ecstatic seizures whose semiology and religious overtones resemble those of Saint Theresa of Avila (1515 to 1582), and discuss the anatomical basis of this phenomenon.

Method: : Case report.

Results: : Evaluation of the patient demonstrated right temporal encephalomalacia on magnetic resonance imaging of the brain. Electroencephalogram showed focal slowing and poorly defined sharp waves in the right frontotemporal region. This area of pathology concurs with prior studies that localize ecstatic seizures to the anterior insula or temporal lobes.

Conclusions: : Ecstatic seizures may involve the right temporal region. Although interpretation of ecstatic seizures is subject to individual variation, a similar localization and our patient's religious background may explain the resemblance between the semiology of his seizures, and that of Saint Theresa's visions as described almost 5 centuries ago.