Ictal visual hallucinations and post-ictal hemianopia with anosognosia

We report the case history of an adult who developed seizures with nearly pure visual symptoms due to an occipital vascular lesion. The seizures were characterized by elementary visual hallucinations in the right visual field. Interictally, a dense homonymous hemianopia was demonstrated in the clinical examination and by using perimetry, but was not recognized by the patient himself. The seizures vanished and the visual fields normalized completely after initiation of anticonvulsive treatment.