Short report: is there anything distinctive about epileptic déjà vu?
- 1Research Department of Infection & Population Health, University College London, London, UK
- 2Department of Neurology, Peninsula Medical School, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, UK
- Correspondence to Professor Adam Zeman, Department of Neurology, Peninsula Medical School, Peninsula College of Medicine and Dentistry, University of Exeter, Room F01, St Luke's Campus, Magdalen Road, Exeter EX1 2LU, UK;
- Received 22 June 2012
- Revised 23 August 2012
- Accepted 11 December 2012
- Published Online First 11 January 2013
Background Déjà vu can occur as an aura of temporal lobe epilepsy and in some psychiatric conditions but is also common in the general population. It is unclear whether any clinical features distinguish pathological and physiological forms of déjà vu.
Methods 50 epileptic patients with ictal déjà vu, 50 non-epileptic patients attending general neurology clinics and 50 medical students at Edinburgh University were recruited. Data were collected on demographic factors, the experience of déjà vu using a questionnaire based on Sno's Inventory for Déjà Vu Experiences Assessment, symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale as well as seizure characteristics, anti-epileptic medications, handedness, EEG and neuroimaging findings for epileptic patients.
Results 73.5% of neurology patients, 88% of students and (by definition) all epilepsy patients had experienced déjà vu. The experience of déjà vu itself was similar in the three groups. Epileptic déjà vu occurred more frequently and lasted somewhat longer than physiological déjà vu. Epilepsy patients were more likely to report prior fatigue and concentrated activity, associated derealisation, olfactory and gustatory hallucinations, physical symptoms such as headaches, abdominal sensations and fear. After controlling for study group, anxiety and depression scores were not associated with déjà vu frequency.
Conclusions Déjà vu is common and qualitatively similar whether it occurs as an epileptic aura or normal phenomenon. However ictal déjà vu occurs more frequently and is accompanied by several distinctive features. It is distinguished primarily by ‘the company it keeps’.