Catalog Forward by Steven C Schacter, MD

I was very pleased to be given the opportunity of writing a Forward to this catalogue, which gave me a chance to reflect on seizures, the temporal lobe and art, and to marvel, once again, in the accomplishments of people with epilepsy.

Epilepsy, the temporal lobe and art. Doctors try to look for cause and effect relationships, which raises the question: are epilepsy and art interrelated? We do know that epilepsy among artists is more or less than the incidence in the general population. There could be as many different ways of viewing the interrelationships as there are types of seizures and temperaments for artists with epilepsy. Yet as one who cares for people with epilepsy, and who has a curiosity about art because of an interest in perception and the ways of viewing the world, I believe there are several possible reasons for a connection between epilepsy and artistic creativity which at least provide some basis for discussion. But first, some words about different types of seizures.

Approximately 3 to 4 million people in the United States have recurrent seizures, including 60,000 in the Commonwealth of Massachusetts. Doctors define an epileptic seizure as a sudden alteration of behavior caused by a temporary surge of electricity in the brain. In particular, seizures arise from the outside rim of the brain called the cortex, which is thought to be the seat of intelligence and conscious awareness. Seizures can be caused by a variety of illnesses or conditions, and can take many different forms, just as there are many different functions of the cortex, such as vision, emotions, movement, sensation, hearing, spatial perception, and everything else that we consciously experience day in and day out. However, any given individual usually experiences a limited number of seizure types.

Quotes from People with T.L.E.

As I mentioned above, seizures are temporary alterations of behavior. Seizures have a definable beginning, middle and end. If someone is aware of the beginning, then the beginning is called a warning, or aura. Auras are electrical surges which affect only a very small part of the cortex; enough to cause symptoms, but not enough to disrupt consciousness. Doctors call auras "simple partial seizures"-- simple means that consciousness is not impaired, and partial means that only part of the brain is affected by seizure. Someone may experience a conscious event during a simple partial seizure that is never experienced under normal circumstances.

Again, the words of people as they express their auras(1).

On the other hand, someone may not have a warning and have no recollection at all of the seizure. This usually happens when the electrical surge happens in the part of the brain that controls memory. When the electrical surge stays within and is limited to the area of the cortex which controls memory (which is the temporal lobe), then the seizure is called a "complex partial seizure" -- complex means that the individual loses consciousness and awareness of their surroundings and as a result cannot meaningfully interact with others during the seizure. Complex partial seizures are the most common type of seizure among adults, and usually cause changes in behavior during the seizure such as staring, or slow, repetitive movements involving the hands, lips or entire body.

For some people, the seizure beings without any warning or staring, as a convulsion, also called a "grand mal seizure".

Once the seizure begins, the middle of the seizure may take several different forms. The aura may turn into a complex partial seizure or may turn into a convulsion. For those who do not have a warning, the seizure may continue as a complex partial seizure or may turn into a convulsion. A convulsion which follows a simple partial seizure or complex partial seizure is called a "secondarily generalized seizure" -- generalized means that the electrical disruption is thought to spread to the entire cortex and so all normal functions of the cortex are temporally shut down.

The end of a seizure presents a transition from a seizure back to a normal state and is called the "post-ictal period" (an ictus is a seizure). It may last from seconds to minutes to hours, depending on several factors including which parts(s) of the brain were affected by the seizure. If a person had a complex partial seizure or a convulsion, their level of awareness gradually improves during the post-ictal period, much like a person waking up from anesthesia after an operation. There are other symptoms which occur during the post-ictal period, such as headaches, fatigue, soreness, nausea, and embarrassment.

Epilepsy means recurrent seizures. Temporal lobe epilepsy means recurrent seizures which originate from the temporal lobe, a part of the brain which is important for language, memory, appetite, sexuality and emotion. Seizures arising from other lobes, such as the frontal lobes, are less common than temporal lobe seizures, but also cause simple and complex partial seizures.

Now back to the possible connections between epilepsy and art. I will offer three, and viewers of this exhibition should discover for themselves whether a particular work of art reflects the artist's epilepsy, and if so, in what way. First, living with epilepsy may compel someone with artistic talent to relate the struggle of living with an unpredictable disorder in a society replete with myths and fears. The quality of life of people with epilepsy is often compromised because of seizures, medication side effects, lack of employment opportunities, and negative societal attitudes.

Listen to the pain of two affected persons(1).

Second, the person who loses consciousness due to seizures may come to value consciousness more than others who take it for granted, having never lost it, and may be inclined to explore the nature of consciousness artistically.

Finally, someone may gain new or novel awareness during seizures. This would be especially true for someone who has simple partial seizures, or auras. I occasionally think of the cortex as an attic from all time, and liken a partial seizure to shining a flashlight in the attic, or the cortex, revealing (producing) feelings or perceptions that are not considered normal, at least for our 20th century culture, such as out-of-body-experiences, premonitions and religious experiences.

It should be acknowledged that there may be no connection between epeilepsy and art for some artists, and just as likely, there may be some artists, not represented in this exhibition, who have epilepsy (especially simple partial seizures) but do not realize it. In addition, independent of any possible connection between epilepsy and art, there is great importance to recognizing the hard work and creative abilities of people with epilepsy. The organizers and contributors to this exhibition are in the right position to see that our culture would be immeasurably enriched if more people with epilepsy were enabled by society to live up to their creative potential.

1. Schacter,S.C. Brainstorms: Epilepsy In Our Words. Raven Press, New York.