A case of focal epilepsy manifesting multiple psychiatric auras

Michinori Ezura, Yosuke Kakisaka, Kazutaka Jin, Kazuhiro Kato, Masaki Iwasaki, Mayu Fujikawa, Masashi Aoki, Nobukazu Nakasato

Research output: Contribution to journalArticle

Abstract

We present a case of epilepsy with multiple types of focal seizures that were misdiagnosed as psychiatric disorders. A 20-year-old female patient presented with a variety of episodes, including loss of consciousness, deja vu, fear, delusion of possession, violent movements, and generalized convulsions. Each of these symptoms appeared in a stereotypic manner. She was initially diagnosed with a psychiatric disorder and treated with psychoactive medications, which had no effect. Long-term video electroencephalography revealed that her episodes of violent movement with impaired consciousness and secondarily generalized seizure were epileptic events originating in the right hemisphere. High-field brain magnetic resonance imaging for detecting subtle lesions revealed bilateral lesions from periventricular nodular heterotopia. Her final diagnosis was right hemispheric focal epilepsy. Carbamazepine administration was started, which successfully controlled all seizures. The present case demonstrates the pitfall of diagnosing focal epilepsy when it presents with multiple types of psychiatric aura. Epilepsy should thus be included in differential diagnoses, considering the stereotypic nature of symptoms, to avoid misdiagnosis.

Original languageEnglish
Pages (from-to)105-109
Number of pages5
JournalBrain and Nerve
Volume67
Issue number1
Publication statusPublished - 2015 Jan 1

Keywords

  • Multiple seizure symptoms
  • Periventricular nodular heterotopia
  • Psychiatric auras

ASJC Scopus subject areas

  • Clinical Neurology

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