HEALTH / Second Opinion

A DOPPELGANGER is an exact double of oneself, seen during normal consciousness. Nineteenth-century writers often used doppelgangers in horror stories: Edgar Allan Poe, Fyodor Dostoevsky and Oscar Wilde all wrote accounts of people terrified by repeated confrontations with their 'second selves'.

The doppelganger is met during normal waking consciousness. By contrast, in an out-of-body experience, an individual who is asleep, recovering from an anaesthetic or, sometimes, a cardiac arrest has the sensation or watching his or her own body from a distance - often as doctors and nurses carry out resuscitation.

Out-of-body and near-death experiences have received a lot of attention in medical journals recently. Doppelgangers, by contrast, are commonly perceived as belonging to an earlier century, rather like vampires and anxieties about being buried alive. In fact, people today may still experience the sensation of persecution by their doubles: the doppelganger seems to be an unusual symptom of a particular kind of epilepsy.

A case report in the Journal of Neurology, Neurosurgery and Psychiatry describes a Swiss man who developed epilepsy at 15. His turns took the form of a sensation of rapid passage of time and feelings of deja vu, sometimes accompanied by dropping objects he held. He was found to have a brain tumour, which was removed, but was kept on anticonvulsant drugs.

His doppelganger experience occurred when he was 21 and had stopped taking anti-epileptic drugs. After an evening's drinking, he got up the next day to find that he could see himself still lying in bed. He became angry that 'this guy who would not get up would be late for work' and tried to wake the body in the bed by shaking it and shouting at it. He became worried that he could not tell which of the two individuals he was - the one asleep or the one trying to wake him up. He found his awareness switching from one to the other, but when he felt himself lying in bed, he was unable of move. Wanting to become one person again, he decided to jump out of the window in the hope that this would frighten the one in the bed. The next thing he remembered was waking up in pain in hospital.

The Zurich doctors who wrote the report have studied both literary horror stories and medical case reports and found a consistent association between epilepsy, doppelganger experiences and suicide. Some of the authors who wrote about sinister doubles - Dostoevsky, for example - were sufferers from epilepsy who might have experienced the doppelganger sensation themselves. In many fictional accounts, the hero commits suicide to escape the horror of being haunted by his second self. Edgar Allen Poe's William Wilson attempts to murder his double and so kills himself.

Some medical reports describe patients who were well aware of the similarity between their own experiences and those of fictional characters. One patient repeatedly compared himself to the hero of Maupassant's Le Horla. He later killed himself.

The experience of seeing a doppelganger is termed heautoscopy and does seem to be closely linked with epilepsy of the temporal lobe kind. The fascinating aspect of the doppelganger/suicide connection is its consistency; the chilling feature is that 100 years after the clear descriptions of the syndrome in literature, doctors still have little to offer its victims.