A case with hyperkinetic frontal lobe epilepsy presenting as a psychiatric disturbance

Elmi H., Kilincaslan A., Ozturk M., Yapici Z.

TURKISH JOURNAL OF PEDIATRICS, vol.53, no.5, pp.574-578, 2011 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 53 Issue: 5
  • Publication Date: 2011
  • Journal Name: TURKISH JOURNAL OF PEDIATRICS
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.574-578
  • Istanbul University Affiliated: Yes

Abstract

We report a case emphasizing the association of epilepsy with psychopathology. The patient was first referred for impulsive and inattentive behavior at the age of 4, and was diagnosed with attention deficit hyperactive disorder. At the age of 7, intermittent daytime episodes characterized with sudden fear and purposeless running, jumping, clapping, and rocking started. Electroencephalography (EEG) recordings did not reveal any abnormality. Two years later, night-time episodes started, which were quite similar to the daytime spells. An overnight EEG showed bilateral frontal spike and wave discharges predominating on the right. Magnetic resonance imaging revealed gliotic changes in the anterior frontal areas, and neuropsychologic assessment findings were compatible with frontal lobe damage. Treatment with carbamazepine not only controlled hyperkinetic motor seizures but also helped interictal inattentiveness and behavioral impulsivity. In our case, ictal behavioral changes were masked by interictal behavioral disturbances and the normal findings in some of EEG records delayed the diagnosis.