TY - JOUR
T1 - A case of focal epilepsy manifesting multiple psychiatric auras
AU - Ezura, Michinori
AU - Kakisaka, Yosuke
AU - Jin, Kazutaka
AU - Kato, Kazuhiro
AU - Iwasaki, Masaki
AU - Fujikawa, Mayu
AU - Aoki, Masashi
AU - Nakasato, Nobukazu
PY - 2015/1/1
Y1 - 2015/1/1
N2 - 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.
AB - 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.
KW - Multiple seizure symptoms
KW - Periventricular nodular heterotopia
KW - Psychiatric auras
UR - http://www.scopus.com/inward/record.url?scp=84922445593&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84922445593&partnerID=8YFLogxK
M3 - Article
C2 - 25585440
AN - SCOPUS:84922445593
VL - 67
SP - 105
EP - 109
JO - Brain and Nerve
JF - Brain and Nerve
SN - 0006-8969
IS - 1
ER -