A Case with Excessive “Kohärenz” (Weizsäcker) as Ictal Experienceand Hypomania following Complex Partial Seizures

Abstract

We reported a case admitted to our seizure monitoring unit for the presurgicalevaluation of temporal lobectomy. At the arrival of the auras, this female patientexperienced that happenings actually irrelevant to her such as conversations in thetelevision suddenly became very personal and every word spoken in the surroundingsseemed to be somehow related to her. This excessive “Kohärenz”, namely excessiveintimacy with the surroundings, corresponded to the nondominant anteriorhippocampal seizure discharge in the depth-EEG. This case was also unique becauseof transient manic states following clusters of complex partial seizures. In view of thepredominance of non-dominant origin of seizures in cases with hypomania followingcomlex partial seizures in the literature, we suggested that it deserved intensive studyto examine the precise relationship between this states and laterality of electroence-phalographical ictal discharge.