Akinetopsia as epileptic seizure☆

Akinetopsia is a rare syndrome in which a patient specifically loses the ability to perceive visual motion following bilateral cortical lesions outside the striate cortex. We describe a patient who showed akinetopsia recurrently as epileptic seizures. The patient was a 61-year-old man. At age 46, a cerebral arteriovenous malformation in the right parietal lobe was discovered. At age 58, he began to have a recurrent visual symptom by which smooth movements of objects suddenly appeared, resembling freeze frames in a motion picture. This symptom was paroxysmal and recurrent. Both EEG and magnetoencephalography showed repetitive right temporal spikes. We diagnosed his visual symptom as akinetopsia, which was aroused by hyperexcitability of the right temporal and parietal cortices, including area MT/V5. We administered carbamazepine 200 mg/day, which suppressed his akinetopsic symptom completely.