Symptomatology of Right Temporal Lobe Lesions

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The right temporal lobe has a paucity of known physiological centers, and lesions in this area may grow to extensive proportions with impunity. Not until perversions of contiguous functions occur do reliable diagnostic phenomena present themselves to the clinician. Frequently no intracranial pathology is suspected until the patient is overwhelmed by the generalized symptoms of increased intracranial pressure. Tumors of the right temporal lobe are imposters, frequently simulating lesions of the frontal lobe, of the ipsolateral and the contralateral cerebellar structures and of the suprasellar region. Moreover, the few focal symptoms referred to the right temporal lobe have not been clearly elucidated as being irritative phenomena on the one hand and ablation signs on the other.

To add to the confusion, several writers have discussed the two temporal lobes indiscriminately, disregarding the fact that the left lobe is the site of internal language which generally yields a rich symptomatology whenever it is assaulted by disease. Thus, Rowe1 reviews 52 cases from Frazier's clinic, stating that visual field disturbances occurred in 29 per cent, cerebellar signs in 53 per cent, mental changes in 50 per cent, and epilepsy in 36 per cent. Auditory defects were encountered in about 25 per cent and uncinate attacks were reported as being infrequent. Koutseff2 submitted a similar study of 59 cases and emphasized the high frequency of hemianopsia and uncinate seizures.

The outstanding symptoms of right temporal lobe disease are centered about the functions of taste, vision, smell and hearing. There may not only be. . .



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