Illusory shadow person causing paradoxical gaze deviations during temporal lobe seizures
Zijlmans, M × van Eijsden, P Ferrier, C H Kho, Kuan Hua van Rijen, P C Leijten, F S S #
British Medical Association
Journal of Neurology, Neurosurgery and Psychiatry vol:80 issue:6 pages:686-8
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.