Frontal nonconvulsive status epilepticus manifesting somatic hallucinations.
Somatic hallucinations are subjective experience of false, strange sensations of things occurring in or to the body. They can be seen in psychotic disorders, but have not been well described as an ictal psychosis in patients with nonconvulsive status epilepticus (NCSE) of frontal origin. We reported a 69-year-old woman who had NCSE of frontal origin manifesting prolonged somatic hallucinations mimicking a psychiatric disorder and initially treated as such. Ictal EEG revealed the frontal focus and ictal single-photon emission computed tomography (SPECT) showed the activation, not only in the frontal area but also in the parietal area as the projected regions, both of which might be associated with the development of her symptoms. She also had two generalized tonic-chronic seizures out of psychosis. Her psychosis and ictal rhythmic discharges on EEG ceased with valproate and she has since remained free from the symptoms. The current case suggests that long-lasting somatic hallucinations could be an ictal psychosis in frontal NCSE and thus an EEG study is needed for an early diagnosis and treatment.
Takaya
Shigetoshi
S
Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan; Kisshoin Hospital, Kyoto, Japan.
Matsumoto
Riki
R
Namiki
Chihiro
C
Kiyosu
Hayaki
H
Isono
Osamu
O
Hashikawa
Kazuo
K
Ikeda
Akio
A
Fukuyama
Hidenao
H
D000368:Aged; D001931:Brain Mapping; D004569:Electroencephalography / Q000379:methods; D004829:Epilepsy, Generalized / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006212:Hallucinations / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods