Complex Visual Hallucinations in Post-stroke Epilepsy: A Case Report and Literature Review

We herein report an 82-year-old man with post-stroke epilepsy (PSE) who presented with persistent complex visual hallucinations (CVH) involving past episodic scenes. Electroencephalography revealed epileptic discharges in the right posterior temporal and parietal regions. The symptoms resolved with levetiracetam and were maintained with zonisamide. A literature review suggested that CVH may occur when epileptic activity spreads to non-dominant temporal or parietal regions. In conclusion, CVH may reflect visual memory and retention and can be accompanied by psychiatric symptoms. Improved recognition of CVH as a manifestation of PSE may help avoid misdiagnoses and lead to appropriate treatment.

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Publication Details

Journal
Internal Medicine
Published
2026-02-14
DOI
https://doi.org/10.2169/internalmedicine.5788-25
Primary Topic
Hallucinations in medical conditions
Type
article
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article

Complex Visual Hallucinations in Post-stroke Epilepsy: A Case Report and Literature Review

Genko Oyama, Mariko Okada, Shugo Fujita, Hitoshi Kawasaki
Internal Medicine
Hallucinations in medical conditions
article

Complex Visual Hallucinations in Post-stroke Epilepsy: A Case Report and Literature Review

Genko Oyama, Mariko Okada, Shugo Fujita, Hitoshi Kawasaki
article en

Abstract

We herein report an 82-year-old man with post-stroke epilepsy (PSE) who presented with persistent complex visual hallucinations (CVH) involving past episodic scenes. Electroencephalography revealed epileptic discharges in the right posterior temporal and parietal regions. The symptoms resolved with levetiracetam and were maintained with zonisamide. A literature review suggested that CVH may occur when epileptic activity spreads to non-dominant temporal or parietal regions. In conclusion, CVH may reflect visual memory and retention and can be accompanied by psychiatric symptoms. Improved recognition of CVH as a manifestation of PSE may help avoid misdiagnoses and lead to appropriate treatment.

Internal MedicineVol. 65(4)
Saitama Medical University (JP)
Good health and well-being
Openalex Percentile: Top 56%
Hallucinations in medical conditions
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Complex Visual Hallucinations in Post-stroke Epilepsy: A Case Report and Literature Review — Genko Oyama, Mariko Okada, et al. · Internal Medicine (2026) | TGRS Research Map | TGRS