Über einen obduzierten fall von optischer körperschemastörung und héautoskopie

Abstract

A case of a glioblastoma verified by post-mortem examination is described. The tumour originated in the left parieto-occipital region and extended itself into the temporal lobe. The patient showed transitory optic disturbances of the body scheme and the phenomenon of autoscopia. Both are very rare brain-pathological sensations. We understand under the term “optic disturbances of the body scheme” the outside-projection of the disturbances of the body scheme into the visual space. It is presupposed that these lesions concern the thalamo-cortical, parieto-occipital and the commissural connections. At the phenomenon of autoscopiat the intact body scheme is transferred in the outside space visually, tactile-kinaesthetically or acoustically. In case of autoscopia at organic cerebral lesions two different forms were found: 1. 1. Autoscopia within the frame of symptomatical epileptic fits. The “double” appears either as a mirror-image or as acting in a scene. 2. 2. Autoscopia characterized by a double who is a kind of permanent companion. The double appears always near the paretic side of the body and can be perceived either by feeling or by seeing. If the double is perceived by seeing a hemianopsia on the side of the double is observed. Cases of autoscopia based on localized cerebral lesions with following necropsy are very rare. Except the referred case only two more other cases are known in the literature. In two cases there were tumours of the parieto-occipital region extending into the temporal lobe. In the third case a tumour of the fronto-temporal region was verified. In all the organic cases of autoscopia without necropsy we assumed parieto-occipital or temporal lesions too. Based on these findings we believe that temporal lesions are connected with attack-like autoscopia showing itself in plurisensoric hallucinations in temporal fits. Besides the focilesions psychodynamic factors are playing an active part in the phenomenon of autoscopia.