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J Neurol Neurosurg Psychiatry 1998;65:275-277 doi:10.1136/jnnp.65.2.275
  • Short report

Pictorial pseudohallucinations with an “aperture effect” in a patient with quadrantanopia

  1. Kai Vogeley,
  2. Gabriel Curio
  1. Department of Neurology, Universitätsklinikum Benjamin Franklin, Free University Berlin, Germany
  1. Dr K Vogeley, Department of Psychiatry and Psychotherapy, Friedrich-Wilhelms-Universität Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany. email: vogeley{at}uni-bonn.de
  • Received 16 June 1997
  • Revised 5 December 1997
  • Accepted 13 January 1998

Abstract

Visual pseudohallucinations are reported on in a patient with a left lower quadrantanopia due to a right parietotemporal surgical defect after tumour removal. Besides metamorphopsia, he hallucinated the lower half of human figures which were limited to within the borders of the anopic defect and appeared “amputated” at the hip with one forearm and hand appearing from above in correct anatomical position. The lower half of these human figures was perceived as correctly scaled in relation to anatomical and environmental coordinates and was recognised as unreal. These pseudohallucinations led to the concept of an “aperture effect” which alludes to the visibility through the anopic field defect of a segment of the contents of the visual association cortex. This supports the idea of a pictorial mode for representation of endogenously generated images in the visual association cortex.

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