Temporal lobe epilepsy and perinatal occlusion of the posterior cerebral artery

In most of eight patients with temporal lobe seizures, the only clearcut neurologic sign was a homonymous hemianopsia or quadrantanopsia. Pneumoencephalography revealed enormous dilation in the parieto-occipital region, with enlargement of the temporal horn. Arteriographic studies, where available, showed occlusion of arteries in the posterior cerebral territory that did not appear to be due to distortion secondary to the dilation of the ventricular system. A perinatal vascular occlusive etiology is suggested in some patients with temporal lobe epilepsy. In a milder form, such a mechanism may be involved in a greater number of patients. There is an analogy between this syndrome, the more commonly encountered infantile hemiplegias, and the vascular lesions described in some patients with focal motor epilepsy.