Revdal Eline, Arntsen Vibeke, Doan Thanh Pierre, Kvello-Alme Marte, Kvistad Kjell Arne, Bråthen Geir, Brodtkorb Eylert
Department of Neurology and Clinical Neurophysiology, St.Olav University Hospital, Trondheim, Norway.
Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
Epilepsy Behav Rep. 2020 Aug 31;14:100386. doi: 10.1016/j.ebr.2020.100386. eCollection 2020.
Ictal visual hallucinations may have occipital as well as temporal lobe origin. We report a patient with clustering of focal aware seizures with visual hallucinations. Ictal EEG findings and seizure semiology with alternating contralateral elementary visual phenomena and non-lateralizing experiential hallucinations (visual scenes, memory flashbacks, spatial distortion) corresponded to a lesion in the posterior part of the right parahippocampal gyrus. This area is part of the hippocampal-parahippocampal system for mapping allocentric space. Within this system, the parahippocampal cortex encodes information about visual environmental scenes in concert with functionally defined neurons relevant for episodic memory and spatial cognitive processes (place, grid, border and head direction cells, as well as neurons tracking the passage of time). These functions are tightly linked to visual exploration. We suggest that the hippocampal-parahippocampal spatial navigation system is a crucial part of the networks responsible for the semiology of experiential seizures with complex visual hallucinations and elements of recall.
发作期视幻觉可能起源于枕叶和颞叶。我们报告了一例伴有视幻觉的局灶性觉知发作簇集的患者。发作期脑电图结果以及发作症状学，表现为交替性对侧基本视觉现象和非定位性体验性幻觉（视觉场景、记忆闪回、空间扭曲），与右侧海马旁回后部的病变相符。该区域是用于绘制空间中心地图的海马 - 海马旁系统的一部分。在这个系统中，海马旁皮质与与情景记忆和空间认知过程相关的功能明确的神经元（位置、网格、边界和头部方向细胞，以及追踪时间流逝的神经元）协同编码有关视觉环境场景的信息。这些功能与视觉探索紧密相连。我们认为，海马 - 海马旁空间导航系统是负责具有复杂视幻觉和回忆元素的体验性发作症状学的神经网络的关键部分。
