title: A case with hyperkinetic frontal lobe epilepsy presenting as a psychiatric disturbance.
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.
authors.affiliation: Department of Child and Adolescent Psychiatry, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey.
authors.forename: Humen
authors.initials: H
authors.lastname: Elmi
authors.forename: Ayşe
authors.initials: A
authors.lastname: Kilinçaslan
authors.forename: Mücahit
authors.initials: M
authors.lastname: Oztürk
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Yapici
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis; D002220:Carbamazepine / Q000627:therapeutic use; D002653:Child Behavior Disorders / Q000209:etiology*; D003937:Diagnosis, Differential; D007174:Disruptive, Impulse Control, and Conduct Disorders / Q000209:etiology; D004569:Electroencephalography; D017034:Epilepsy, Frontal Lobe / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D006948:Hyperkinesis / Q000150:complications; D008279:Magnetic Resonance Imaging
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine