title: Alternative psychosis and dysgraphia accompanied by forced normalization in a girl with occipital lobe epilepsy.
abstract: An 11-year-old girl who had been given antiepileptic drugs (AEDs) for occipital lobe epilepsy was hospitalized with alternative psychosis and dysgraphia accompanied by forced normalization of the EEG. Her epileptic seizures and psychosis disappeared after administration of carbamazepine. She developed dysgraphia for Kanji words (Japanese morphograms). The EEG showed sporadic spikes predominantly in the left occipital region, and [123I]iomazenil single-photon-emission computed tomography (IMZ-SPECT) imaging revealed an area of hypoperfusion in the left occipital lobe. Interestingly, the left posterior inferior temporal area is known to play an important role in writing Kanji words. It is assumed that abnormal discharges in the left occipital lobe were projected into the left posterior inferior temporal area and that a functional disorder in that area led to dysgraphia; however, further exploration is needed.
authors.affiliation: Department of Pediatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan. yossy-h@pf7.so-net.ne.jp <yossy-h@pf7.so-net.ne.jp>
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Hirashima
authors.forename: Masafumi
authors.initials: M
authors.lastname: Morimoto
authors.forename: Akira
authors.initials: A
authors.lastname: Nishimura
authors.forename: Toshio
authors.initials: T
authors.lastname: Osamura
authors.forename: Tohru
authors.initials: T
authors.lastname: Sugimoto
mesh_terms: D000381:Agraphia / Q000139:chemically induced* / Q000000981:diagnostic imaging; D000927:Anticonvulsants / Q000009:adverse effects*; D002220:Carbamazepine / Q000009:adverse effects*; D002648:Child; D004569:Electroencephalography / Q000379:methods; D004828:Epilepsies, Partial / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D005442:Flumazenil / Q000031:analogs & derivatives; D006801:Humans; D011618:Psychotic Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine; D005442:Flumazenil; C063038:iomazenil