Three patients from different racial, social, and economic backgrounds
were studied because of sudden intrusive thoughts: visions or intrusions of
threatening scenes--violent, aggressive, and sometimes horrifying--that
lasted from seconds to minutes. Apart from the association with intense
anxiety, fear, and aggression, there was no association with oculomotor,
motor, sensory, or autonomic dysfunction or altered conscious state.
Patients had abnormal intermittent discharges that arose from frontal areas
and probably did not spread further. Carbamazepine was useful in two cases.
The authors suggest that violent, brief hallucinations with no other
epileptic sign may be manifestations of frontal lobe seizures.Abstract Teaser