The anatomical correlate of epileptic seizures with ecstatic auras has not been established. We document precise descriptions of the ecstatic seizures experienced by five patients, all of whom reported intense feelings of well-being and a heightened self-awareness. We propose here that the descriptions by these patients, together with the neurophysiological and neuroradiological evidence, support a theoretical framework for understanding ecstatic states based on hyperactivation of the anterior insula, rather than the temporal lobe. Epileptologists who have access to patients who experience episodic feelings of ecstasy and heightened self-awareness have an opportunity to provide insights that might help clarify the neural basis of consciousness.