Brain, Vol. 110, No. 2, 339-359, 1987
© 1987 Oxford University Press
research-article |
GUSTATORY HALLUCINATIONS IN EPILEPTIC SEIZURES
ELECTROPHYSIOLOGICAL, CLINICAL AND ANATOMICAL CORRELATES
Unite de Recherches 97 sur l'Epilepsie, INSERM, et Service de Neurochirurgie Fonctionnelle de l'Hôpital Sainte-Anne, Paris
Correspondence to:
Correspondence to: Dr. Jean Bancaud, Unite de Recherches 97, INSERM, 2, Rue d'Alesia, F-75014, Paris, France
Of the 718 patients investigated for intractable epilepsy by stereoelectrocencephalographic (SEEG) exploration, 30 (4%) manifested gustatory hallucinations as part of their seizures. In 20 patients, it was possible to make some electrophysiological, clinical and anatomical correlates. (1) Gustalory hallucinations occurred as one manifestation of parietal, temporal or temporoparietal seizures. (2) A brief isolated gustatory hallucination was induced mainly by electrical stimulation of the parietal or rolandic opercula in patients with gustatory seizures, in 1 epileptic patient with parietotemporal epilepsy who had never experienced gustatory hallucinations and in another with temporal lobe epilepsy with no history of gustatory manifestations. (3) The electrically-induced seizures, which included a gustatory hallucination as one of the ictal events, were obtained mainly by stimulation of the hippocampus and amygdala. (4) The associated ictal events of a seizure with gustatory manifestations differed , they consisted of staring reactions, clonic contractions of the face, deviation of the eyes and salivation. During temporal lobe seizures, they consisted of staring reactions, clonic contractions of the face, deviation of the eyes and salivation. During temporal lobe seizures, the associated events included mainly oral movements, autonomic disturbances, purposeless movements and epigastric or other abdominal symptoms. Seizures affecting both the infra and suprasylvian regions were characterized by symptoms of both categories listed above. Emotional disturbances were observed mainly when there was an involvement of the cingulate gyrus. (5) When care was taken to avoid methodological errors in the interpretation of the clinical signs occurring after electrical stimulation, it became clear that gustatory hallucinations in man were related to the disorganization of the parietal and/or rolandic operculum. (6) The spontaneous or electrically–induced temporal lobe seizures which included gustatory hallucinations as an ictal event probably spread to the opercular region by a functional reorganization of the connections within these epileptogenic areas.
Received May 20, 1986. Accepted June 10, 1986.
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