Lateralising value of experiential hallucinations in temporal lobe epilepsy

Heydrich, Lukas; Marillier, Guillaume; Evans, Nathaniel; Blanke, Olaf; Seeck, Margitta

doi:10.1136/jnnp-2014-309452

Cited by 8 publications

(10 citation statements)

References 17 publications

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“…For the display of the seizure onset zone in patients with DV and EH please refer to the original work by Heydrich et al…”

Section: Resultsmentioning

confidence: 99%

“…altered perception of one’s surroundings that is experienced as strange or unreal) as part of their habitual seizure semiology . Moreover, patients reporting déjà vu (DV) or experiential hallucinations (EH) were selected from the same population as an additional control group (see ). Patients were only included if they could be unequivocally assigned to one of the above mentioned four groups according to their semiology.…”

Section: Methodsmentioning

confidence: 99%

“…In the present study we aimed to investigate the neural correlates of DP and DR by analysing clinical and neuropsychological data in a group of patients with epilepsy suffering from focal epilepsy and ictal DP‐ and DR‐like phenomena. Given the historical link of both DP‐ and DR‐like phenomena as part of experiential phenomena with temporal lobe epilepsy, we also investigated a control group consisting of patients suffering from déjà vu or experiential hallucinations due to temporal lobe epilepsy, as reported previously . We localized the epileptogenic zone, using a multimodal approach as described previously .…”

Section: Introductionmentioning

confidence: 99%

“…Given the historical link of both DP‐ and DR‐like phenomena as part of experiential phenomena with temporal lobe epilepsy, we also investigated a control group consisting of patients suffering from déjà vu or experiential hallucinations due to temporal lobe epilepsy, as reported previously . We localized the epileptogenic zone, using a multimodal approach as described previously . In addition, we analyzed our patients’ symptoms with respect to the recently introduced concept of bodily self‐consciousness (BSC) (see ).…”

Section: Introductionmentioning

confidence: 99%

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Depersonalization‐ and derealization‐like phenomena of epileptic origin

Heydrich

Marillier

Evans

et al. 2019

Ann Clin Transl Neurol

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Objective Depersonalization refers to the sensation of being detached from one’s body, often associated with feelings of loss of control over one’s own body, actions, or thoughts. Derealization refers to the altered perception of one’s surroundings that is experienced as unreal. Although usually reported by psychiatric patients suffering from depression or anxiety, single case reports and small case series have described depersonalization‐ and derealization‐like symptoms in the context of epilepsy. Methods We investigated the brain mechanisms of ictal depersonalization– and derealization like symptoms by analyzing clinical and neuropsychological data as well as the epileptogenic zone based on a multimodal approach in a group of patients reporting depersonalization‐ (n = 9) and derealization‐like symptoms (n = 7), from a single presurgical epilepsy center with focal epilepsy. We compared them with a group of control patients with experiential phenomena due to temporal lobe epilepsy (n = 28). Results We show that all patients with ictal depersonalization‐like symptoms report altered self‐identification with their body and mostly suffer from frontal lobe epilepsy with the epileptogenic zone in the dorsal premotor cortex, while patients with derealization‐like symptoms suffer from temporal lobe epilepsy. This finding is supported by post‐ictal neuropsychological deficits, showing that depersonalization‐like symptoms were significantly more often associated with frontal lobe dysfunction as compared to the control patients and patients with derealization‐like symptoms. Conclusion We argue that depersonalization of epileptic origin constitutes a distinct disorder due to frontal lobe epilepsy. We discuss these findings with respect to earlier accounts of depersonalization and the recent concept of bodily self‐consciousness.

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“…For the display of the seizure onset zone in patients with DV and EH please refer to the original work by Heydrich et al…”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Depersonalization‐ and derealization‐like phenomena of epileptic origin

Heydrich

Marillier

Evans

et al. 2019

Ann Clin Transl Neurol

Self Cite

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“…Gupta et al (1983) found that right hemispheric EEG abnormalities were more likely in patients with psychic or autonomic auras. Heydrich et al (2015) suggest a lateralising value for experiential hallucinations to the left temporal lobe.…”

Section: Heinz Gregor Wiesermentioning

confidence: 96%

Presurgical diagnosis of epilepsies – concepts and diagnostic tools

Wieser

2016

Journal of Epileptology

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Introduction. Numerous reviews of the currently established concepts, strategies and diagnostic tools used in epilepsy surgery have been published. The focus concept which was initially developed by Forster, Penfield and Jasper and popularised and enriched by Lüders, is still fundamental for epilepsy surgery. Aim. To present different conceptual views of the focus concept and to discuss more recent network hypothesis, emphasizing so-called "critical modes of an epileptogenic circuit". Method. A literature search was conducted using keywords: presurgical evaluation, epileptic focus concepts, cortical zones, diagnostic tools. Review and remarks. The theoretical concepts of the epileptic focus are opposed to the network hypothesis. The definitions of the various cortical zones have been conceptualized in the presurgical evaluation of candidates for epilepsy surgery: the seizure onset zone versus the epileptogenic zone, the symptomatogenic zone, the irritative and functional deficit zones are characterized. The epileptogenic lesion, the "eloquent cortex" and secondary epileptogenesis (mirror focus) are dealt with. The current diagnostic techniques used in the definition of these cortical zones, such as video-EEG monitoring, non-invasive and invasive EEG recording techniques, magnetic resonance imaging, ictal single photon emission computed tomography, and positron emission tomography, are discussed and illustrated. Potential modern surrogate markers of epileptogenicity, such as High frequency oscillations, Ictal slow waves/DC shifts, Magnetic resonance spectroscopy, Functional MRI, the use of Magnetized nanoparticles in MRI, Transcranial magnetic stimulation, Optical intrinsic signal imaging, and Seizure prediction are discussed. Particular emphasis is put on the EEG: Scalp EEG, semi-invasive and invasive EEG (Stereoelectroencephalography) and intraoperative electrocorticography are illustrated. Ictal SPECT and 18 F-FDG PET are very helpful and several other procedures, such as dipole source localization and spike-triggered functional MRI are already widely used. The most important lateralizing and localizing ictal signs and symptoms are summarized. It is anticipated that the other clinically valid surrogate markers of epileptogenesis and epileptogenicity will be further developed in the near future. Until then the concordance of the results of seizure semiology, localization of epileptogenicity by EEG and MRI remains the most important prerequisite for successful epilepsy surgery. Conclusions and future perspectives. Resective epilepsy surgery is a widely accepted and successful therapeutic approach, rendering up to 80% of selected patients seizure free. Although other therapies, such as radiosurgery, and responsive neurostimulation will increasingly play a role in patients with an unresectable lesion, it is unlikely that they will replace selective resective surgery. The hope is that new diagnostic techniques will be developed that permit more direct definition and measurement of the epileptogenic zone.

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Consciousness

Cavanna¹

2016

Neuropsychiatric Symptoms of Neurological Disease

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Lateralising value of experiential hallucinations in temporal lobe epilepsy

Abstract: These results suggest a lateralising value for experiential hallucinations to the left temporal lobe.

Cited by 8 publications

References 17 publications

Depersonalization‐ and derealization‐like phenomena of epileptic origin

Depersonalization‐ and derealization‐like phenomena of epileptic origin

Presurgical diagnosis of epilepsies – concepts and diagnostic tools

Consciousness

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