Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
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.
Devinsky O. Temporal Lobe Epilepsy and Auditory Symptoms. JAMA. 2003;290(18):2407. doi:10.1001/jama.290.18.2407-a