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Epilepsiu.
40(2).239-241,
1999
Lippincott Williams
Kr
Wilkin\, Inc., Philadelphia
0
nternational League Against
Epilep~y
Brief
Communication
Epilepsy and Religious Experiences:Voodoo Possession
E.
Carrazana,
J.
DeToledo, W. Tatum, R. Rivas-Vasquez,
G.
Rey, and
S.
Wheeler
Neurologic
Cenenter
o;f
South Florida, University
o
Miami School
o
Medicine,
and
University
oj
South
Floi-idu-Tampa
General
HoJpitul, Miami, Floridu,
U.S.A.
Summary:
Epileptic seizures have a historical associationwith 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 attributionis 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 theepilepsies. A common belief of ancient cultures was thatmental disturbances were caused by supernatural inter-ference. The early Greeks viewed epilepsy as a visitationfrom 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 withepilepsy themselves have often explained their seizuresas religious experiences, particularly the feelings associ-ated with depersonalization, derealization, and autoscopyof temporal lobe epilepsy. Furthermore, most of the re-ports invoke elements of Christianity, thereby reflectinga Eurocentric view of the subject
(1).
Voodoo is the most popular religion in Haiti. It haspreserved many of the characteristics of the Dahomeanand Guinean cults from which it derives (2). Worshipand 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 theychoose. The person possessed is
a
mere receptacle bor-rowed by the spirit for the purpose of revealing itself. Inthat sense, the experience is similar to an epileptic sei-zure in that the patient has no control over its timing norexpression. 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 OutpatientBldg.,
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 casesdemonstrate that beliefs and folklore are not alwaysharmless in that, at times, they can adversely affect clini-cal management. In addition to being a source of greatanxiety, they may delay appropriate diagnosis and treat-ment.
CASES
Case 1
This 24-year-old Haitian man had his first generalizedtonic-clonic seizure at the age of 17 years during thewake of an uncle. The patient had been sleep deprivedduring the vigil of the corpse. The seizure was attributedto possession by
Ogu
(the warrior god), the dead uncle’sprotecting
loa.
Subsequent seizures and morning myoc-lonus were explained as harassment by the wanderingsoul of the uncle. The possession was interpreted as apunishment, for the patient had been disrespectful towardthe deceased in the past. He was treated by the local
mambo
(priest) for
6
years and did not see a physicianuntil coming to the United States. His EEG showed
3-
to4-Hz bursts of generalized spike-wave complex dis-charges occurring spontaneously and during photicstimulation. In retrospect, the patient had a history ofwaking 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 ofcomplex partial and secondarily generalized seizures
239
240 E.
CARRAZANA
ET
AL.
since adolescence, was the product of
a
long and difficultdelivery, which was attributed to
a
“grip” in the moth-er’s belly by
a
loa.
At the age of 14 years, she fell in anopen fire during
a
seizure and suffered extensive burns toher arm, leg, and parts of the face and trunk. Burns weretreated at
a
local hospital, but the family brought thepatient back to the
mambo
to treat the “possession.”This incident was interpreted by the mambo
as
posses-sion by ‘‘Marinnette.”
Marinnette-bwa-chech
is one ofthe most dreaded
loas,
an agent for underhand dealingsand an expert sorceress. Those possessed by this
loa
aresaid to throw themselves in the fire and stamp about untilthey put the flames out. The patient had bitemporal in-dependent spikes on EEG. Treatment with antiepilepticdrugs (AEDs) has decreased the frequency of seizures.
Case
3
This 36-year-old woman had several years of recurrentcomplex partial seizures that manifested
as
a strongsense of fear and epigastric coldness, followed by loss ofawareness, utterances of nonsensical phrases, and com-plex motor automatisms. The local
mambo
attributed theevents to her being taken by
“Melle Charlotte,”
a
french
loa,
with the nonsensical speech being interpreted
as
aforeign language. It is said that during the possession bythis spirit,
a
person will speak perfect French or otherlanguages, even though in life, the person has no knowl-edge of that language. She continued to have seizuresdespite the
mambo’s
attempts to conjure the spirit. Heexplained his failure to the fact that
Melle Charlotte
is
a
very particular
loa
who makes only sporadic appear-ances. She was not treated with AEDs until she left Haitiat the age of
34.
An EEG revealed
a
right anterior tem-poral focus, and magnetic resonance imaging (MRI)showed right hippocampal atrophy. Seizures improvedwith carbamazepine (CBZ), although compliance withmedication was
a
problem, largely because of familyinterference.
Case
4
This 44-year-old Dominican woman (of Haitian par-ents) for years has been experiencing partial seizureswhich she refers to
as
“la cosa”
(the thing). Her sei-zures, with
a
sudden overwhelming sensation of empti-ness, were attributed to her “good angel” leaving her
as
the spirit of the dead tried to take hold of her
(“memandaron un muerto”).
The sending of the dead,
l
’envois
morts,
is a
feared Voodoo curse, which is said toaffect health and prosperity. The
mambo
explained thefailure of the attacks to respond to his exorcisms to thestrong hold of the spirit.
EEG
showed
a
right temporalfocus, and the
MRI
was normal. Seizures were controlledwith phenytoin (PHT) monotherapy.
Case
5
This 47-year-old Jamaican woman of Haitian descentwith
a
history of Chiari
I
malformation, syringomyelia,and arrested hydrocephalus, has a long-standing historyof complex partial seizures with and without secondarygeneralization. The patient and her family attributed
the
seizures to Voodoo spirit possessions, being influencedby the olfactory hallucination of
a
burning smell, and
a
rising epigastric aura “taking over the body.”
A
pro-longed postictal psychosis would follow, in which
the
patient would alternate chanting and wooing with peri-ods of total unresponsiveness. EEG demonstrated inde-pendent bitemporal interictal epileptiform discharges.She denied her diagnosis of epilepsy, resisted diagnosticand therapeutic interventions, and insisted that she
was
possessed by spirits of the dead. On immigrating to the.United States, she ultimately became seizure free withPHT monotherapy.
DISCUSSION
Possession by spirits is part of many African cults.Their influence was spread to the New World by theslave trade. From the ports of Benin, Dahomey, andGuinea, natives were sold
as
slaves
primarily to the colo-nies in the Caribbean basin and Brazil. Holds of slavescontained representatives of all social classes including“servants of the gods,” who knew the cults’ rites andkept them alive in exile. Many of their descendants haveheld onto these traditions to the present, because of eithergeographic isolation or sociocultural constraints and in-fluences
or
both. Attempts to eliminate slave cults in thecolonies were not very successful because of
a
lax po-litical authority and resistance to Church interference inslave matters on the part of land owners. This influenceis clear in the synchretic religions that developed there-after, such
as
Santeria in Cuba, Mayombe in Brazil,Espiritismo in Mexico, Obeah in the Bahamas, and
Voo-
doo in Haiti
(2).
Many people in Haiti still adhere to the practice ofVoodoo and believe implicitly in magic. Voodoo,
as
it ispracticed today, is not substantially different from theDahomean cults of the 17th and 18th century, except forhuman sacrifice, which was then widely practiced. InDahomey,
a
voodoo
is
a
“god,”
a
“spirit,” or
a
“sacredobject”
(2).
The spirits, the worship of whom is theessence of Voodoo, are called
loas,
mysteries, saints, orangels. Not only do they range from known Catholicsaints to the old gods from Africa, but minor local spiritsalso are worshiped. Voodoo is always enriching itselfwith new
loas;
some are revealed and imposed on mem-bers of
a
cult group when
a
devotee
is
suddenly pos-sessed by an unknown spirit who demands worship; oth-ers owe their existence to dreams, particularly of influ-ential mambos
(2).
This dynamism of Voodoo,
as
illustrated in cases
2
and
3,
allows simple religious con-cepts to provide explanations for
a
range of life circum-stances,including health matters.
Epilcpsia
Vd
40,
No.
2,
1999
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