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Seminar 11-11-2009
Lakshya J. Basumatary, M.D. DM (Neurology) Trainee
Association areas
Redrawn from Geschwind N: Specializations of
the human brain. Sci Am 241:180, 1979.
Blood supply
• Posterior cerebral arteries (PCA)
• "fetal" posterior cerebral artery
• Inferior division of the middle cerebral artery
(parietotemporal branch)
• Posterior callosal branch of Anterior cerebral
artery (ACA)
MRA
Superior sagittal sinus
IJV
• Psychovisual reflexes
– Fixation reflex
– Optically elicited fixation movement
– Follow movement
– Convergence/divergence
– Corrective fusional movements (Holmes 1938)
Visual memory,visualization and the visual
elements of dream
Charcot-Wilbrand syndrome
visual agnosia
loss of visualization
loss of visual elements in dreaming
Effects of unilateral disease, either right or left
Menace reflex
Optokinetic Reflex
Blink Reflex
EEG
Associated Neurologic deficit
Tests for Occipital lobe disorders
Color naming,
color form association, and visual memory,
recognition of faces of prominent people,
map drawing
Color matching tests (Nagel cards)
Weigl’s color-form sorting test
Photograph of famous person
Visual field test
Occipital lobe and Seizure
• Relatively uncommon
• Lacks recruiting response
• 25% of cases (Gibbs 1932, whitty 1955)
• Generalized seizure > focal
– Oculoclonic
– Oculogyric deviation
– Clonic palpebral jerks
– Forced closer of eyelids
– Forced eye turning (parieto-occipitlal)
Childhood epilepsy with occipital paroxysms
• Heterogenous
• Late onset- Gastaut type
• Panayiotopoulos syndrome
EEG
Interictal - high amp,2-3 hz SSWc(posterior quadrant)
Ictal-prominent occipital discharge with spread +
Panayiotopoulos syndrome