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Lippincott Williams Kr Wilkin\, Inc., Philadelphia 0 International League Against Epilep~y
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 f Miami School o f Medicine, and University o j 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 possession. Five cases where epileptic seizures were initially attributed to Voodoo spirit possession are presented. The attribution
is discussed within the context of the Voodoo belief system. Key Words: Epilepsy-Seizures-Religion-VoodooPossessions.
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 interference. The early Greeks viewed epilepsy as a visitation from the gods, and thus a sacred disease. Christians during medieval times followed the biblical belief of demonic possessions (Matthew 17:14-1 8). Persons with epilepsy themselves have often explained their seizures as religious experiences, particularly the feelings associated with depersonalization, derealization, and autoscopy of temporal lobe epilepsy. Furthermore, most of the reports 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 Voodoo; 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 borrowed by the spirit for the purpose of revealing itself. In that sense, the experience is similar to an epileptic seizure in that the patient has no control over its timing nor expression. Voodoo faithfuls voluntarily place themselves under the authority of some priest/priestess (hungun, mambo), with the interpretation of beliefs depending 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 attributed to possession by Voodoo spirits. These cases demonstrate that beliefs and folklore are not always harmless in that, at times, they can adversely affect clinical management. In addition to being a source of great anxiety, they may delay appropriate diagnosis and treatment.
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 myoclonus 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 discharges occurring spontaneously and during photic stimulation. In retrospect, the patient had a history of waking myoclonus, which had been ignored. He remained seizure free after treatment with valproic acid (VPA). The likely diagnosis is juvenile myoclonic epilepsy. Case 2 This 27-year-old Haitian woman, with a history of complex partial and secondarily generalized seizures
” or a “sacred object” (2). Holds of slaves contained representatives of all social classes including “servants of the gods. . She denied her diagnosis of epilepsy. He explained his failure to the fact that Melle Charlotte is a very particular loa who makes only sporadic appearances. some are revealed and imposed on members of a cult group when a devotee is suddenly possessed by an unknown spirit who demands worship.” a “spirit. In Dahomey. 2. was the product of a long and difficult delivery. and Guinea. in which the patient would alternate chanting and wooing with periods of total unresponsiveness. Those possessed by this loa are said to throw themselves in the fire and stamp about until they put the flames out. Seizures were controlled with phenytoin (PHT) monotherapy. Many of their descendants have held onto these traditions to the present. except for human sacrifice. Case 5 This 47-year-old Jamaican woman of Haitian descent with a history of Chiari I malformation. which is said to affect health and prosperity. has a long-standing history of complex partial seizures with and without secondary generalization. allows simple religious concepts to provide explanations for a range of life circumstances. The sending of the dead. with the nonsensical speech being interpreted as a foreign language. a voodoo is a “god. followed by loss of awareness. and Voodoo in Haiti (2).” a french loa. particularly of influential mambos (2). Case 4 This 44-year-old Dominican woman (of Haitian parents) for years has been experiencing partial seizures which she refers to as “la cosa” (the thing). EEG showed a right temporal focus. she ultimately became seizure free with PHT monotherapy. and insisted that she was possessed by spirits of the dead. Case 3 This 36-year-old woman had several years of recurrent complex partial seizures that manifested as a strong sense of fear and epigastric coldness. although compliance with medication was a problem. The spirits. This influence is clear in the synchretic religions that developed thereafter. An EEG revealed a right anterior temporal focus. because of either geographic isolation or sociocultural constraints and influences or both. as it is practiced today. 1999 DISCUSSION Possession by spirits is part of many African cults. others owe their existence to dreams. l ’envoismorts. Espiritismo in Mexico. with a sudden overwhelming sensation of emptiness. syringomyelia. Epilcpsia V d 40. The mambo explained the failure of the attacks to respond to his exorcisms to the strong hold of the spirit. She continued to have seizures despite the mambo’s attempts to conjure the spirit. largely because of family interference. and complex motor automatisms.240 E. Attempts to eliminate slave cults in the colonies were not very successful because of a lax political authority and resistance to Church interference in slave matters on the part of land owners. which was then widely practiced.” A prolonged postictal psychosis would follow. Burns were treated at a local hospital. N o . Mayombe in Brazil. Their influence was spread to the New World by the slave trade. being influenced by the olfactory hallucination of a burning smell.” Marinnette-bwa-chech is one of the most dreaded loas. the worship of whom is the essence of Voodoo. Seizures improved with carbamazepine (CBZ). and magnetic resonance imaging (MRI) showed right hippocampal atrophy. resisted diagnostic and therapeutic interventions. EEG demonstrated independent bitemporal interictal epileptiform discharges.including health matters. is a feared Voodoo curse. which was attributed to a “grip” in the mother’s belly by a loa.” who knew the cults’ rites and kept them alive in exile. From the ports of Benin. utterances of nonsensical phrases. or angels. and the MRI was normal. Dahomey. United States. Obeah in the Bahamas. but minor local spirits also are worshiped. Voodoo. The patient and her family attributed the seizures to Voodoo spirit possessions. saints. but the family brought the patient back to the mambo to treat the “possession. This dynamism of Voodoo. as illustrated in cases 2 and 3. The patient had bitemporal independent spikes on EEG. the person has no knowledge of that language. and arrested hydrocephalus. Not only do they range from known Catholic saints to the old gods from Africa. Her seizures. On immigrating to the. natives were sold as slaves primarily to the colonies in the Caribbean basin and Brazil. Voodoo is always enriching itself with new loas. and a rising epigastric aura “taking over the body. she fell in an open fire during a seizure and suffered extensive burns to her arm. were attributed to her “good angel” leaving her as the spirit of the dead tried to take hold of her (“me mandaron un muerto”).” This incident was interpreted by the mambo as possession by ‘‘Marinnette. It is said that during the possession by this spirit. She was not treated with AEDs until she left Haiti at the age of 34. are called loas. leg. since adolescence. CARRAZANA ET AL. an agent for underhand dealings and an expert sorceress. At the age of 14 years. Many people in Haiti still adhere to the practice of Voodoo and believe implicitly in magic. The local mambo attributed the events to her being taken by “Melle Charlotte. Treatment with antiepileptic drugs (AEDs) has decreased the frequency of seizures. a person will speak perfect French or other languages. mysteries. even though in life. such as Santeria in Cuba. is not substantially different from the Dahomean cults of the 17th and 18th century. and parts of the face and trunk.
Ann Neurol 1982. Although we are in no position to deny a true Voodoo spirit possession. the lack of control. The neural substrates of religious experiences. A guardian role is attributed to the “Little Good Angel. J Neuropsychol Clin Neurosci 1997. Catherine of Ricci.” which can total hundreds of dollars in each case. Patricia de la Torre for their invaluable help in preparing the manuscript.EPILEPSY AND VOODOO POSSESSIONS In Voodoo circles. and double consciousness are common in patients with a temporal lobe focus (6) and have been elicited during intraoperative stimulation of the amygdala. epileptic seizures should be considered in the differential diagnosis of atypical and episodic religious experiences. Epilepsia. Heathfield KWG. Naito H. derealization. Voodoo tradition holds that humans have two souls. No. Temporal lobe epilepsy with ictal ecstatic state and interictal behavior of hypergraphia. It is a relatively common experience of those with temporal lobe epilepsy. can also be affiliated with religious experiences. New York: Schcken Books. Autoscopic phenomena with seizures. Matsui N. Other features common to both conditions are the abruptness. et al. Doss R. Herson RA. and Catherine of Genoa have been considered examples of ecstatic epilepsy (lo). This failure was attributed to the uniqueness of the loa in one case and the unyielding grip of the loa in the other.47:35-59. and first temporal gyrus (7. it finds itself unable to cope. Simpson GE.23:12944. Divine horsemen: The living gods of Haiti. Bruin 1971. however. Metraux A. the generalized tonic-clonic seizure’s timing and severity lead the mambo to incriminate the deceased’s protecting loa. 5. 2. Depersonalization. cases as these are more likely the application of cultural and religious beliefs to otherwise unexplainable occurrences by a medically unsophisticated population. 11. et al. Vol. an important point particularly in areas with a high percentage of new immigrants. New York: Thames and Hudson. hippocampus. which is sought after and desired. the physician must take into account the patient’s cultural background and system of beliefs. Gates JR. Brown. Penfield W.42:1183-7. possession and trance are not regarded as cause for shame or even anxiety. The description of pseudoseizures in the literature is quite similar (5).9:498-510. 6. The symptoms accompanying epileptogenic discharges in the temporal lobe are fertile ground for mystic interpretations. and the possessed remembers nothing of what was said or done. Ictal characteristics of pseudoseizures. Loewenson R. REFERENCES 1. Scott DF. with their complex partial seizures misconstrued as possessions. Whalen S. Feldmann E. Voodoo in Haiti. The sleep deprivation and the flickering effect of the flames at the wake may have triggered the seizure in this patient with probable juvenile myoclonic epilepsy. 1954. et al. Medical help was not sought until the patient moved away from the native town. Arch Neurol 1985. Tradition has it that either act can be punished with revenge and deliverance of even worse ailments ( 2 ) . as in case 1.94: 173-90. 4. either at the onset of the seizure or during the postictal phase (9). Burrowes K. although less common features of temporal lobe partial seizures. The role of the limbic system in experiential phenomena of temporal lobe epilepsy. 10. The services of the mambo required periodic “contributions. Clinical course and prognosis of temporal lobe epilepsy. The intensity of the crisis varies according to the character of the spirit seeking incarnation (2). 1953. 9. J Nerv Ment Dis 1988. The patients and families acknowledged that they feared going against the lous or disobeying the mambos. are frequently interpreted as celestial voices and visions 241 as well (11). Regardless of the faith. Saver JL. which is frightening and morbid (2). 7 . Esther Dominguez and Ms. Similar feelings also are described with religious conversions (1). make a clear distinction between possession by a “radu” loa. As case 1 illustrates. Epilepsy and the functional anatomy of the human bruin. Jasper H. the “Big” and the “Little” good angels. or the sensation of leaving the body and viewing it from above. Arch Neurol 1989. in likelihood. Theresa of Avila. Oliver A.8). 1959. Possession by loas takes place when the loa drives out the “Big Good Angel. and possession by evil spirits from the “petro” family of loas. Auditory and visual hallucinations. they are a mark of divine favor (4). The trance is typically followed by a period of sleep or confusion. the nature of the incarnated loa was identified by the mambo based on the clinical manifestations of the epilepsy. Autoscopy. 1999 . 40. When treating patients. Ramani V. Rabin J. Patients 2 through 5 have temporal lobe epilepsy. through weariness or any other reason. Gloor P. Possession by petro loas is often delivered by sorcerers as punishment. Engehrit B. Mendez MF. 176:1234.” The eviction of the soul is responsible for the tremblings and convulsions that characterize the trance. Quesney LF. Devinsky 0. Acknowledgment: We are indebted to Mrs. The relationship of epileptic auras and psychological attributes.” Serious illness takes hold only when the guardian has been overwhelmed by evil spirits stronger than itself or when. The belief system of Haitian Vodun. the depth.46: 1080-8. Boston: Little. 3. The mystical experiences of Saints Paul.8:287-92. Am Anthropol 1945. and the perceptual changes occurring during the seizures. Thus we could appreciate how easily an epileptic seizure may be attributed to a spirit possession by a medically unsophisticated mambo. Deren M. The patients and relatives pursued treatments with mambos for many years despite the persistence of seizures. J Neuropsychol Clin Neurosci 1996. Currie S. 2. 8. Adepts of Voodoo.
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