Auditory verbal hallucinations of epileptic origin.
Complex auditory hallucinations are often characterized by hearing voices and are then called auditory verbal hallucinations (AVHs). While AVHs have been extensively investigated in psychiatric patients suffering from schizophrenia, reports from neurological patients are rare and, in most cases, incomplete. Here, we characterize AVHs in 9 patients suffering from pharmacoresistant epilepsy by analyzing the phenomenology of AVHs and patients' neuropsychological and lesion profiles. From a cohort of 352 consecutively examined patients with epilepsy, 9 patients suffering AVHs were identified and studied by means of a semistructured interview, neuropsychological tests, and multimodal imaging, relying on a combination of functional and structural neuroimaging data and surface and intracranial EEG. We found that AVHs in patients with epilepsy were associated with prevalent language deficits and damage to posterior language areas and basal language areas in the left temporal cortex. Auditory verbal hallucinations, most of the times, consisted in hearing a single voice of the same gender and language as the patient and had specific spatial features, being, most of the times, perceived in the external space, contralateral to the lesion. We argue that the consistent location of AVHs in the contralesional external space, the prominence of associated language deficits, and the prevalence of lesions to the posterior temporal language areas characterize AVHs of neurological origin, distinguishing them from those of psychiatric origin.
Center for Neuroprosthetics, School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; Laboratory of Cognitive Neuroscience, Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
Andrea
A
Serino
Center for Neuroprosthetics, School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; Presurgical Epilepsy Evaluation Unit, "Functional Neurology and Neurosurgery" Program of the University Hospitals Lausanne and Geneva, Switzerland; Department of Neurology, University Hospital, Geneva, Switzerland.
Lukas
L
Heydrich
Presurgical Epilepsy Evaluation Unit, "Functional Neurology and Neurosurgery" Program of the University Hospitals Lausanne and Geneva, Switzerland; Department of Neurology, University Hospital, Geneva, Switzerland.
Mary
M
Kurian
Presurgical Epilepsy Evaluation Unit, "Functional Neurology and Neurosurgery" Program of the University Hospitals Lausanne and Geneva, Switzerland; Department of Neurology, University Hospital, Geneva, Switzerland.
Laurent
L
Spinelli
Presurgical Epilepsy Evaluation Unit, "Functional Neurology and Neurosurgery" Program of the University Hospitals Lausanne and Geneva, Switzerland; Department of Neurology, University Hospital, Geneva, Switzerland.
Margitta
M
Seeck
Center for Neuroprosthetics, School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; Laboratory of Cognitive Neuroscience, Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland; Presurgical Epilepsy Evaluation Unit, "Functional Neurology and Neurosurgery" Program of the University Hospitals Lausanne and Geneva, Switzerland; Department of Neurology, University Hospital, Geneva, Switzerland. Electronic address: olaf.blanke@epfl.ch.
Olaf
O
Blanke
D000328:Adult; D015331:Cohort Studies; D004827:Epilepsy / Q000150:complications*; D005260:Female; D006212:Hallucinations / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests
Electrical cortical stimulation; Epileptic monitoring; Hallucinations