The Russian writer Fyodor Mikhailovich Dostoevsky (1821–1881) is deemed to have had temporal lobe epilepsy, which manifested as seizures of varying semiology through his lifespan. Most biographers date Dostoevsky's first epileptic seizure to the year 1846, although he was known to have experienced epilepsy-related acoustic hallucinations in childhood. He has documented a range of seizures, from simple partial seizures, complex partial seizures through to generalised tonic–clinic secondary generalisation, as well as nocturnal seizures in late life. He describes in great detail the triggers, prodromal states and variety of auras, as well as the postictal consequences, including ‘mystical depression’. The semiology and provenance of his seizures have been contested and it is now acknowledged that he had a mixture of epileptic seizures and non-epileptic attacks.
Dostoevsky created characters with epilepsy in various novels, including Murin in the The Landlady (1847), Nellie in The Insulted and Injured (1861), Prince Myshkin in The Idiot (1868), Kirillov in The Possessed (1871) and Smerdyakov in The Brothers Karamazov (1879), ascribing his personal experiences to them.
For instance, he has described his own ‘ecstatic aura’ or prodromal states, which he used to effect in two important protagonists, Prince Myshkin and Kirillov. Prince Myshkin describes ‘a moment of overflowing with unbounded joy and rapture, ecstatic devotion, and completest life […] I would give my whole life for this one instant’. He has used this to create a template for a moment of extraordinary significance which transcends a lifetime of ordinary events. In Myshkin's case, the auras end with generalised seizures, whereas Kirillov has one or two auras a week, but never experiences full-blown seizures. Dostoyevsky clearly knew about the possibility that isolated auras may precede the manifestation of full seizures for a long period, which was not common knowledge at the time.
Elements of the contentious Gastaut–Geschwind syndrome, which is characterised by hypergraphia, hyper-religiosity and circumstantiality, have been attributed to Dostoevsky himself and he notably uses them in the character of Prince Myshkin. Dostoevsky uses epilepsy as a metaphor for both goodness and guilelessness in Myshkin and for evil in Smerdyakov, where it provides an alibi for a criminal act. Smerdyakov, who suffers from epileptic seizures for most of his life, murders his father Fyodor Pavlovich Karamazov while simulating status epilepticus. This highlights Dostoevsky's understanding of non-epileptic attack disorder.
Dostoevsky wrote at times that he was grateful for his seizure disorder because of the ‘abnormal tension’ the episodes created in his brain but he also regretted it as he felt that it had a lasting impact on his memory. However, it remains notable that he has been able to transmute his illness into art, both as a literary device and in the detailed descriptions of the illness itself, including its more obscure aspects.
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