Interictal perceptual function in epilepsy

Epilepsy can affect perception. Ictal perceptual experiences are common, but interictal perceptual function may also be affected. This article reviews the English-language literature on interictal perceptual disturbances in epilepsy. Although most studies report impaired perceptual ability, heightened sensitivity has also been described. There is a compelling, though not absolute, correlation between affected sensory modality and underlying epilepsy syndrome. Olfaction is clearly affected in temporal lobe epilepsy, while visual information processing is disturbed in occipital lobe epilepsy. The cause of interictal perceptual dysfunction is unknown, but propagating epileptiform discharges may play a role. The presence of specific perceptual disturbances in focal epilepsy syndromes is consistent with the view that epilepsy is a network disease, with the potential to affect neural circuits distant from the seizure focus. The use of thoughtfully selected psychophysical perceptual tasks may provide additional insight into the cognitive impact of different epilepsy syndromes and of ablative epilepsy surgery.