title: "God has sent me to you": Right temporal epilepsy, left prefrontal psychosis.
abstract: Religious experiences have long been documented in patients with epilepsy, though their exact underlying neural mechanisms are still unclear. Here, we had the rare opportunity to record a delusional religious conversion in real time in a patient with right temporal lobe epilepsy undergoing continuous video-EEG. In this patient, a messianic revelation experience occurred several hours after a complex partial seizure of temporal origin, compatible with postictal psychosis (PIP). We analyzed the recorded resting-state EEG epochs separately for each of the conventional frequency bands. Topographical analysis of the bandpass filtered EEG epochs revealed increased activity in the low-gamma range (30-40Hz) during religious conversion compared with activity during the patient's habitual state. The brain generator underlying this activity was localized to the left prefrontal cortex. This suggests that religious conversion in PIP is related to control mechanisms in the prefrontal lobe-related processes rather than medial temporal lobe-related processes.
authors.affiliation: Neuropsychiatry Lab, Department of Neurology, Hadassah Hebrew University Medical Center, Jerusalem 9112001, Israel; Department of Medical Neuroscience, Faculty of Medicine, The Hebrew University, Jerusalem 9112001, Israel. Electronic address: shahar.arzy@ekmd.huji.ac.il.
authors.forename: Shahar
authors.initials: S
authors.lastname: Arzy
authors.affiliation: Neuropsychiatry Lab, Department of Neurology, Hadassah Hebrew University Medical Center, Jerusalem 9112001, Israel.
authors.forename: Roey
authors.initials: R
authors.lastname: Schurr
mesh_terms: D003702:Delusions; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000150:complications / Q000000981:diagnostic imaging / Q000523:psychology*; D007839:Functional Laterality; D065818:Gamma Rhythm; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000000981:diagnostic imaging / Q000209:etiology / Q000523:psychology*; D012069:Religion and Psychology; D012640:Seizures / Q000000981:diagnostic imaging / Q000523:psychology
keywords: Delusion; EEG; Postictal psychosis; Religious