Palinopsia Preceding a Seizure in a Patient with Arteriovenous Malformation in the Occipito-Temporal Lobe

ABSTRACT

Palinopsia means a visual image persisting for minutes to hours or reappearing episodically after the exciting stimulus has been removed. The anatomic correlation of palinopsia is not clear, whereas occipito-parietal and occipito-temporal lesions have been implicated. We describe a patient presenting palinopsia prior to motor seizures which was related to left posterior temporal lesion. A 36-year-old man had a generalized tonic clonic seizure after palinoptic positive visual afterimages. Brain MRI and Transfemoral cerebral angiography (TFCA) revealed an arteriovenous malformation of 1x1.5x2 cm3. We used oxcarbazepine for preventing recurrent seizures and planned gamma knife radiosurgery. Palinopsia is a very rare clinical manifestation as an aura of seizures. Palinopsia preceding clinical seizure as a localizing value, so that neuroimaging is mandatory in this clinical situation. This is the first reported case of palinopsia in Korea.