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November 12, 2003

Temporal Lobe Epilepsy and Auditory Symptoms

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290(18):2407. doi:10.1001/jama.290.18.2407-a

In Reply: In response to Dr Gordon, there is evidence that van Gogh had several disorders, including major depression, epilepsy, absinthe toxicity, and Meniere disease.1,2 These are not mutually exclusive diagnoses.

Isolated tinnitus or vertigo as the symptom of a seizure focus in or near auditory cortex is indeed rare, but this symptom can be evoked by electrical stimulation in humans. This patient's syndrome, however, did not involve isolated tinnitus or vertigo. Rather, he reported paroxysmal and brief episodes of vertigo combined with distortion of limb size, déjà vu, and other symptoms characteristic of a temporal lobe seizure focus. This combination of symptoms, as well as the time course of symptoms and response to antiepileptic drugs, would be extremely atypical for peripheral eighth nerve disorders.

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