Hostname: page-component-7b7567c8c-7pwfn Total loading time: 0 Render date: 2026-11-15T11:27:56.501Z Has data issue: false hasContentIssue false
  • English
  • Français

Complex visual hallucinations and occipital seizures

Published online by Cambridge University Press:  24 June 2014

Mark Walterfang,
Raju Yerra,
Francesco Gaillard,
Terence O’Brien,
Ramon Mocellin and
Dennis Velakoulis
Mark Walterfang*
Affiliation:
Neuropsychiatry Unit, Royal Melbourne Hospital, Victoria, AustraliaMelbourne Neuropsychiatry Centre, University of Melbourne, Victoria, Australia
Raju Yerra
Affiliation:
Department of Neurosciences, Royal Melbourne Hospital, Victoria, AustraliaDepartment of Medicine, Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia
Francesco Gaillard
Affiliation:
Department of Radiology, Royal Melbourne Hospital, Victoria, Australia
Terence O’Brien
Affiliation:
Department of Neurosciences, Royal Melbourne Hospital, Victoria, AustraliaDepartment of Medicine, Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia
Ramon Mocellin
Affiliation:
Neuropsychiatry Unit, Royal Melbourne Hospital, Victoria, AustraliaMelbourne Neuropsychiatry Centre, University of Melbourne, Victoria, Australia
Dennis Velakoulis
Affiliation:
Neuropsychiatry Unit, Royal Melbourne Hospital, Victoria, AustraliaMelbourne Neuropsychiatry Centre, University of Melbourne, Victoria, Australia
*
Dr Mark Walterfang, Neuropsychiatry Unit Level 2, John Cade Building, Royal Melbourne Hospital, Parkville 3050, Victoria, Australia. Tel: +61 3 93428750; Fax: +61 3 93428483; E-mail: mark.walterfang@mh.org.au
Get accessRights & Permissions [Opens in a new window]

Abstract

Background:

We describe the presentation of a young woman with long-standing complex partial seizures with occasional secondary generalization, who presented with complex visual hallucinations (CVHs) and delusions.

Methods:

Routine biological workup including magnetic resonance imaging revealed an area of significant left-sided occipital gliosis. Video telemetry monitoring revealed a left occipital focus for the origin of the electrographic seizure discharge.

Conclusion:

CVHs occur in a range of organic states, including epilepsy, and can be understood in terms of the underpinning neuroanatomy and neurotransmitter systems of the visual system.

Keywords

epilepsyhallucinationshallucinosisoccipitalvisual

Information

Type
Case report
Information
Acta Neuropsychiatrica , Volume 19 , Issue 6 , December 2007, pp. 376 - 379
Copyright
Copyright © 2007 Blackwell Munksgaard

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Folstein, M, Folstein, S, McHugh, P. “Mini mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198. CrossRefGoogle ScholarPubMed
Walterfang, M, Siu, R, Velakoulis, D. The NUCOG: validity and reliability of a brief cognitive screening tool in neuropsychiatric patients. Aust N Z J Psychiatry 2006;40:995–1002. CrossRefGoogle ScholarPubMed
Taylor, I, Scheffer, I, Berkovic, S. Occipital epilepsies: identification of specific and newly recognised syndromes. Brain 2003;126:753–769. CrossRefGoogle Scholar
Dreifuss, F. Proposal for classification of epilepsies and epileptic syndromes: Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia 1985;26:268–278. Google Scholar
Mocellin, R, Walterfang, M, Velakoulis, D. The neuropsychiatry of complex visual hallucinations. Aust N Z J Psychiatry 2006;40:742–751. CrossRefGoogle ScholarPubMed
Manford, M, Andermann, F. Complex visual hallucinations: clinical and neurobiological insights. Brain 1998;121:1819–1840. CrossRefGoogle ScholarPubMed
Salanova, V, Andermann, F, Olivier, A, Rasmussen, T, Quesney, L. Occipital lobe epilepsy: electroclinical manifestations, electrocorticography, cortical stimulation and outcome in 42 patients treated between 1930 and 1991. Brain 1992;115:1655–1680. CrossRefGoogle ScholarPubMed
Blume, W, Whiting, S, Girvin, J. Epilepsy surgery in the posterior cortex. Ann Neurol 1991;29:638–645. CrossRefGoogle ScholarPubMed
Bien, C, Benninger, F, Urbach, H, Schramm, J, Kurthen, M, Elger, C. Localizing value of epileptic visual auras. Brain 2000;123:244–253. CrossRefGoogle ScholarPubMed
Panayiotopoulos, C. Elementary visual hallucinations, blindness and headache in idiopathic occipital epilepsy: differentiation from migraine. J Neurol Neurosurg Psychiatry 1999;66:536–540. CrossRefGoogle ScholarPubMed
Panayiotopoulos, C. Visual phenomena and headache in occipital epilepsy: a review, a systematic study and differentiation from migraine. Epileptic Disord 1999;1:205–216. Google ScholarPubMed
Gloor, P, Olivier, A, Quesney, L, Andermann, F, Horowitz, S. The role of the limbic system in experiential phenomena of temporal lobe epilepsy. Ann Neurol 1982;12:129–144. CrossRefGoogle ScholarPubMed
Penfield, W, Jasper, H. Epilepsy and the functional anatomy of the human brain. Boston: Little Brown, 1954. Google Scholar
Palmini, A, Andermann, F, Dubeau, F, Gloor, P, Olivier, A, Quesney, L. Occipitotemporal epilepsies: evaluation of selected patients requiring depth electrodes studies and rationale for surgical approaches. Epilepsia 1993;34:84–96. CrossRefGoogle ScholarPubMed
Williamson, P, Thadani, V, Darcey, T, Spencer, D, Spencer, S, Mattson, R. Occipital lobe epilepsy: clinical characteristics, seizure spread patterns, and results of surgery. Ann Neurol 1992;31:3–13. CrossRefGoogle Scholar
Aykut-Bingol, C, Bronen, R, Kim, J, Spencer, D, Spencer, S. Surgical outcome in occipital lobe epilepsy: implications for pathophysiology. Ann Neurol 1998;44:60–69. CrossRefGoogle ScholarPubMed
Goldberg, S, Klerman, G, Cole, J. Changes in schizophrenic psychology and ward behaviour as a function of phenothiazine treatment. Br J Psychiatry 1965;111:120–133. CrossRefGoogle ScholarPubMed
Bracha, H, Wolkowitz, O, Lohr, J, Karson, C, Bigelow, L. High prevalence of visual hallucinations in research subjects with chronic schizophrenia. Am J Psychiatry 1989;146:526–528. Google ScholarPubMed
Tracy, D, Shergill, S. Imaging auditory hallucinations in schizophrenia. Acta Neuropsychiatrica 2007;18:71–78. CrossRefGoogle Scholar
Walterfang, M, Mocellin, R, Velakoulis, D. Visual hallucinations in consultation-liaison neuropsychiatry. Acta Neuropsychiatrica 2007 (in press).CrossRefGoogle ScholarPubMed
Cutting, J. The phenomenology of acute organic psychosis. Comparison with acute schizophrenia. Br J Psychiatry 1987;151:324–332. CrossRefGoogle ScholarPubMed
Feinstein, A, Ron, M. Psychosis associated with demonstrable brain disease. Psychol Med 1990;20:793–803. CrossRefGoogle ScholarPubMed
Johnstone, E, Cooling, N, Frith, C, Crow, T, Owens, D. Phenomenology of organic and functional psychoses and the overlap between them. Br J Psychiatry 1988;153:770–776. CrossRefGoogle Scholar
Sachdev, P. Schizophrenia-like psychosis and epilepsy: the status of the association. Am J Psychiatry 1998;155:325–336. CrossRefGoogle ScholarPubMed