Deja vu in temporal lobe epilepsy.

Hughlings Jackson was the first to demonstrate that paroxysmal deij vu (called by him 'reminiscence') is significantly related to disease of the temporosphenoidal region (Jackson, 1880, 1888; Jackson and Colman, 1898; Jackson and Purves-Stewart, 1899). Although he mentioned several cases of dieja vu with left-sided lesions (Jackson, 1888; Jackson and Colman, 1898) in his view the phenomenon arises much more frequently in cases in which the focus of discharge is in the right cerebral hemisphere (Jackson, 1880). This view failed to gain general acceptance, but has been revived following recent reports from the Montreal Neurological Institute that psychical seizures characterized by an aura of familiarity occur predominantly as the result of discharge or stimulation in the temporal lobe of the hemisphere minor for handedness and speech (Penfield, 1958). This predominance is stated to be of the order of 9: 1 (Mullan and Penfield, 1959). One may add that their claim derives some support from Bingley's (1958) careful analysis of the psychic symptoms relating to the temporal lobe. In the present paper an attempt will be made to establish the incidence of deja vu in psychomotor epilepsy in relation to the laterality of the focus and the handedness of the patient. A review of the records of 110 cases of psychomotor epilepsy yielded 27 cases in which the evidence of a unilateral focus was considered sufficiently clear cut to justify operation. Fourteen of these proved to be cases of temporal lobe tumour. The records were then carefully scrutinized for reports of de7ja vu or any closely related illusion of familiarity having occurred as an integral part of the seizure pattern or as an abnormally frequent and vivid experience between attacks. We found 13 cases, 10 of these being of tumour, in which we were both satisfied that the abnormal experience described by the patient had in fact been one of deja vu. A brief analysis of the findings in these cases and in the 14 in which no dejai vu was reported follows.