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Perceiving “ghost” images: a unique case of visual allesthesia with hemianopsia in mitochondrial disease

Authors Murakami H, Ichikawa H, Sugimoto A, Futamura A, Shimizu Y, Sugie M, Miller M, Kawamura M

Received 30 January 2014

Accepted for publication 21 March 2014

Published 5 June 2014 Volume 2014:10 Pages 999—1002


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Peer reviewer comments 4

Hidetomo Murakami,1 Hiroo Ichikawa,2 Azusa Sugimoto,1 Akinori Futamura,1 Yuki Shimizu,2 Masayuki Sugie,2 Michael W Miller,3 Mitsuru Kawamura1

Department of Neurology, Showa University School of Medicine, Tokyo, Japan; 2Department of Neurology, Showa University Fujigaoka Hospital, Yokohama, Japan; 3MD/PhD Program, University of Tokyo Postgraduate School of Medicine, Tokyo, Japan

Abstract: A 49-year-old man with mitochondrial disease presented with visual allesthesia,
a rare and puzzling phenomenon. He was admitted for treatment because of convulsions. After the convulsions ceased, he exhibited left homonymous hemianopsia. Brain diffusion-weighted magnetic resonance imaging (MRI) showed a high-intensity area in the right occipital lobe. Both the hemianopsia and the MRI activation in this area disappeared by day 36 of hospitalization. On the morning of day 57, right homonymous hemianopsia emerged in a singular manner. The patient perceived an illusory object (a bottle placed by the bedside) in his left visual field, while the real object was in his blind right field. This case of visual allesthesia was ­accompanied by palinopsia, ie, perseveration of the image of the bottle. Diffusion-weighted MRI showed a new, high-intensity area in the left occipital lobe. We believe the visual allesthesia resulted from transfer of cortical information obtained by blindsight between hemispheres as a result of epileptic excitation.

Keywords: visual allesthesia, blindsight, palinopsia, mitochondrial disease, epilepsy

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