Orientation and disorientation: Lessons from patients with epilepsy

Michael Peer, Ronit Lyon, Shahar Arzy*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

29 Scopus citations

Abstract

Orientation in time, space, and person is a fundamental cognitive faculty and the bedrock of neurological and psychiatric mental status examination. Nevertheless, research in orientation and disorientation is neglected in both cognitive science and neuropsychiatry. Specifically, it is still unclear whether disorientations in time, space, and person represent a failure of the same system or merely share a common nomenclature and whether these three domains of orientation depend on different psychological and neural systems. Here, we analyzed descriptions of patients with specific orientation failures associated with circumscribed cortical lesions, with a primary focus on epilepsy. The form of disorientation is analyzed according to its specific domain, the underlying neuropsychiatric disorder, and its anatomical correlate. Disorientations in the different domains are classified as self-referenced (incorrect self-localization) or nonself-referenced (incorrect localization or knowledge of other places, events, and people). Analysis of the cognitive and neural systems disturbed in these patients suggests that disorientation in one or several domains may be related to a failure in a specific brain mechanism localized mostly in the right hemisphere, partially overlapping with the default mode network (mostly the medial and lateral parietal, medial temporal, and lateral prefrontal cortices), which processes essential self-related cognitive faculties such as orientation.

Original languageAmerican English
Pages (from-to)149-157
Number of pages9
JournalEpilepsy and Behavior
Volume41
DOIs
StatePublished - 1 Dec 2014

Bibliographical note

Publisher Copyright:
© 2014 Elsevier Inc.

Keywords

  • Disorientation
  • Epilepsy
  • Person
  • Place
  • Self
  • Space
  • Time

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