DAVID C TAYLOR, MOIRA LOCHERY
From the University
Department of Psychiatry
The study of aura has a respectable history since the introduction of the term
by Pelops, the master of Galen,3 to describe the "breath of air" which was his patient's premonition of
a seizure. Reported auras seem stable between cultures and over historical time.
Bernard of Gordon's patient reported "a confusion in the head, and a darkness in the eyes" (1 542)4 and
Gastaut etal (1959)5 "a black fog before the eyes".
Persinger:
[Religious oriented temporal lobe epilepsy]
Anatomical origin of d??j?? vu
and vivid 'memories' in human temporal lobe epilepsy
Article in Brain · March 1994
DOI:
10.1093/brain/117.1.71 · Source: PubMed
As Jackson had also observed, the dreamy state could
occur alone but was often associated with epigastric phenomena and fear, and
followed by loss of contact and oro-alimentary automatisms, and then by simple
gestural automatisms, all characteristic of partial seizures beginning in the
medial temporal lobe. Furthermore, as also emphasized by Jackson the dreamy state
was seldom associated with sensory illusions.
Patient 13:
described after habitual seizures, a feeling
of strangeness and unreality of the environment, with the feeling of dija vicu
that he could not better describe. Questioning during an evoked seizure
revealed that this 'dija vicu' corresponded to a sudden memory of a very
elaborate scene. During another seizure, provoked by stimu- lation of the same
structure, and with the same electrographic evolution, the same patient could
only report a feeling of strangeness of the
environment.
References:
Ferguson SM, Rayport M, Gardner R, Kass W, Weiner H,
Reiser MF. Similarities in mental content of psychotic states, spontaneous
seizures, dreams, and responses to electrical brain stimulation in patients
with temporal lobe epilepsy. Psychosom Med 1969; 31: 478-98.
Gloor P, Olivier A, Quesney LF. The role of
the amygdala in the expression of psychic phenomena in temporal lobe seizures.
In: Ben-Ari Y, editor. The amygdaloid complex. Amsterdam: Elsevier/North-Holland
Biomedical Press, 1981: 489-98.
Penfield W. The role of the
temporal cortex in certain psychical phenomena. J Ment Sci 1955; 101: 451-65.
Penfield
W, Perot P. The brain's record of auditory and visual experience: a final
summary and discussion. Brain 1963; 86: 595-696.
Schneider RC, Crosby EC, Bagchi BK, Calhoun
HD. Temporal or occipital lobe hallucinations triggered from frontal lobe
lesions.
Neurology 1961;
11: 72-9.
PSYCHICAL PHENOMENA IN TEMPORAL LOBE
EPilEPSY AND TIE PSYCHOSES*
BY
SHAFICA KARAGULLA, MiD., M.R.C.P.Ed.
D.P.M.
Department of Neurology and Neurosurgery, McGill
University and Montreal Neurological
Institute
AND
E. ELIZABETH ROBERTSON, M.B., F.R.C.P.Ed.
D.P.M.
Royal Edinburgh Hospital for Mental and Nervous
Disorders
The experiences which we describe and illustrate may
be stated thus: (1) The experiencing of " thoughts "-such thoughts being either indefinite or formulated. (2) The hearing of " voices " within the mind or body or from a point external to the self. (3) The seeing of persons, objects, or scenes, which, again, may be perceived within the mind or at some point external to the self.
[The patient] fell down during the attack and tried to overcome it by mental effort, whereupon he was aware of all his thoughts transforming themselves into vivid external visual images. He was so terrified by this that he kept changing his thoughts, but
each thought continued to transform itself into a visual image. For instance, he thought of fire-crackers, and suddenly these were seen in sunset colours of blue and mauve in front of his eyes located "about a block
away," seeming to tumble down through the sky but never reaching him. Then he thought of a space
ship, and it appeared as a pinkish-blue object, moving towards him, becoming smaller as it did so.
Semiologic and Electrophysiologic
Correlations in Temporal Lobe
Seizure Subtypes
∗†Louis
Maillard, †Jean-Pierre Vignal, ∗Martine Gavaret, ∗Maxime
Guye, ‡Arnaud Biraben,
∗Aileen
McGonigal, ∗Patrick Chauvel, and ∗Fabrice
Bartolomei
Sensory illusions and hallucinations:
In this study, as previously proposed
(33,34), we separated pure sensory illusions or hallucinations from vivid
hallucinations, vivid recollections of scenes, and from the sensation of d´ej`a-vu.
Psychosis in epilepsy patients
Siddhartha
Nadkarni, Vanessa Arnedo, and Orrin Devinsky
Epileptic psychoses reflect a fundamental
disruption in the fidelity of mind and occur during seizure freedom or during
or after seizures. The psychotic symptoms in epilepsy share some qualities with
schizophrenic psychosis, such as positive symptoms of paranoid delusions and
hallucinations. Psychotic syndromes in epilepsy are most common but not
exclusively associated with temporal lobe epilepsy.
ICTAL PSYCHOSIS
Ictal psychosis is rare:
cognitive, affective, and hallucinatory symptoms of partial epilepsy combine to
produce a psychotic state (Wells, 1975).Most partial seizures last under 3 min,
and the psychic symptoms evoked during such transient spells rarely cause
symptoms that would be considered psychotic. Ictal psychosis relates most
commonly to visual or auditory illusions
and hallucinations combined with affective changes, such as agitation or fear
or paranoia.
Other psychic phenomena of
partial epilepsy include deper- sonalization, derealization, autoscopy, out of
body experience, or a sense of “someone behind.” These ictal experiential phenomena most often localize to
the temporal lobe with activation of limbic and neocortical temporal areas.
Prolonged ictal psychotic states are rare…
