title: Prefrontal disturbances as the sole manifestation of simple partial nonconvulsive status epilepticus.
abstract: We describe a case of frontal lobe epilepsy with rare nocturnal generalized tonic-clonic seizures and repeated prolonged episodes of altered behavior lasting 1 to 2 days. The changes consisted of poor organizational strategies, impaired set shifting, emotional indifference, reduced motivation, and impairment of emotional decision making. Memory and consciousness were undisturbed, as she was able to follow her profession as a teacher. During the episode, the EEG was marked by right frontal rhythmical spikes and waves with spread to the homologous left region. Behavioral abnormalities and EEG changes were successfully treated with intravenous diazepam. The clinical representation can be ascribed to alterations of prefrontal-subcortical circuits, especially the anterior cingulate and orbitofrontal circuits. This unique case is classified as simple partial nonconvulsive status epilepticus with prefrontal disturbances as the sole manifestation.
authors.affiliation: Universitätsklinik für Neurologie Medizinischen Universität Innsbruck, Innsbruck, Austria. Gerhard.Bauer@uibk.ac.at
authors.forename: Gerhard
authors.initials: G
authors.lastname: Bauer
authors.forename: Judith
authors.initials: J
authors.lastname: Dobesberger
authors.forename: Richard
authors.initials: R
authors.lastname: Bauer
authors.forename: Norbert
authors.initials: N
authors.lastname: Embacher
authors.forename: Thomas
authors.initials: T
authors.lastname: Benke
authors.forename: Iris
authors.initials: I
authors.lastname: Unterberger
authors.forename: Gerald
authors.initials: G
authors.lastname: Walser
authors.forename: Gerhard
authors.initials: G
authors.lastname: Luef
authors.forename: Eugen
authors.initials: E
authors.lastname: Trinka
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D003975:Diazepam / Q000627:therapeutic use; D004569:Electroencephalography; D017034:Epilepsy, Frontal Lobe / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000473:pathology*; D013226:Status Epilepticus / Q000175:diagnosis*
chemical_list: D000927:Anticonvulsants; D003975:Diazepam