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Updated: May 24, 2026

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Published on: September 20, 2024
Occipital lobe epilepsy with fear as leading ictal symptom
Bernhard Oehl1, Andreas Schulze-Bonhage, Michael Lanz
1Epilepsy Center, University Hospital Freiburg, Breisacher Straße 64, 79106 Freiburg, Germany. bernhard.oehl@uniklinik-freiburg.de
Abstract:
Ictal fear is a semiological feature which is commonly associated with mesial temporal lobe epilepsy. Here, we describe fear as a leading symptom in cryptogenic occipital lobe epilepsy. In a patient with negative MRI findings, intracranial EEG recordings documented a strict correlation between habitual ictal anxiety attacks and both spontaneous and stimulation-induced epileptic activity in a right occipital epileptogenic area with subsequent spreading to the symptomatogenic zone in the amygdala. Circumscribed occipital topectomy led to seizure freedom. Episodes of non-epileptic fear ceased shortly afterwards. This report provides insight into pathways of propagation of epileptic activity, illustrates different etiologies of pathologic fear and underlines the importance of ictal EEG recordings.
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