It is difficult to determine from published papers just what level of clinical difficulty self-induction of seizures actually posed to the patients and clinicians. In some cases there is contradictory evidence as to the degree of willfulness or self-induction. Self-induced epileptic seizures may be an important aspect of poor seizure control in a subgroup of epilepsy sufferers. These seizures might be modifiable by psychiatric intervention or behavioural modification.

This study investigates the characteristic features of trance states in three different ethnic communities (Chinese, Malays and Indians) in Singapore by administering a semi-structured interview to 55 patients with the condition and analysing witnesses’ accounts. Trance disorder among the three groups displays remarkable similarities in phenomenology but differences also exist. Most of the trances were reportedly precipitated by fear, anger and/or frustration. Seventy per cent of patients reported prodromal symptoms. Common manifestations include unusual vocalizations and movements, shaking, apparent immunity from pain, and unfocused or fixed gaze. The patients tend to assume the identities of gods from their own cultures. For individuals reported to be possessed by deities, the embodied identities are gods lower down in the hierarchy of Chinese gods or a minor supernatural figure on the Hindu pantheon. The recognizable prodromal symptoms and hierarchy among the gods may have therapeutic implications.

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