Illusory shadow person causing paradoxical gaze deviations during temporal lobe seizures.
Generally, activation of the frontal eye field during seizures can cause versive (forced) gaze deviation, while non-versive head deviation is hypothesised to result from ictal neglect after inactivation of the ipsilateral temporo-parietal area. Almost all non-versive head deviations occurring during temporal lobe seizures are directed to the side of seizure onset, so in derogatory cases it is worth while explaining the paradoxical event. We present a patient with a paradoxical direction of gaze deviation during temporal lobe seizures with an unexpected explanation. Electrocortical stimulation of the temporo-parieto-occipital junction elicited an irrepressible urge to look towards an illusory shadow person besides the patient. Paradoxical non-versive gaze deviations in temporal lobe seizures may be due to illusory experiences masked by postictal amnesia.
Zijlmans
M
M
Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, The Netherlands. g.j.m.zijlmans@umcutrecht.nl
van Eijsden
P
P
Ferrier
C H
CH
Kho
K H
KH
van Rijen
P C
PC
Leijten
F S S
FS
D000328:Adult; D001931:Brain Mapping; D004292:Dominance, Cerebral / Q000502:physiology*; D004558:Electric Stimulation; D004567:Electrodes, Implanted; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology* / Q000601:surgery; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D005403:Fixation, Ocular / Q000502:physiology; D005625:Frontal Lobe / Q000503:physiopathology; D006212:Hallucinations / Q000503:physiopathology; D006801:Humans; D018670:Monitoring, Ambulatory; D009778:Occipital Lobe / Q000503:physiopathology; D009903:Optical Illusions / Q000502:physiology*; D009949:Orientation / Q000502:physiology*; D010296:Parietal Lobe / Q000503:physiopathology; D012815:Signal Processing, Computer-Assisted; D013702:Temporal Lobe / Q000503:physiopathology