title: [A case of focal epilepsy manifesting multiple psychiatric auras].
abstract: We present a case of epilepsy with multiple types of focal seizures that were misdiagnosed as psychiatric disorders. A 20-year-old female patient presented with a variety of episodes, including loss of consciousness, deja vu, fear, delusion of possession, violent movements, and generalized convulsions. Each of these symptoms appeared in a stereotypic manner. She was initially diagnosed with a psychiatric disorder and treated with psychoactive medications, which had no effect. Long-term video electroencephalography revealed that her episodes of violent movement with impaired consciousness and secondarily generalized seizure were epileptic events originating in the right hemisphere. High-field brain magnetic resonance imaging for detecting subtle lesions revealed bilateral lesions from periventricular nodular heterotopia. Her final diagnosis was right hemispheric focal epilepsy. Carbamazepine administration was started, which successfully controlled all seizures. The present case demonstrates the pitfall of diagnosing focal epilepsy when it presents with multiple types of psychiatric aura. Epilepsy should thus be included in differential diagnoses, considering the stereotypic nature of symptoms, to avoid misdiagnosis.
authors.affiliation: Department of Epileptology, Tohoku University Graduate School of Medicine.
authors.forename: Michinori
authors.initials: M
authors.lastname: Ezura
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kakisaka
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Jin
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kato
authors.forename: Masaki
authors.initials: M
authors.lastname: Iwasaki
authors.forename: Mayu
authors.initials: M
authors.lastname: Fujikawa
authors.forename: Masashi
authors.initials: M
authors.lastname: Aoki
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Nakasato
mesh_terms: D002220:Carbamazepine / Q000008:administration & dosage / Q000627:therapeutic use*; D003243:Consciousness / Q000502:physiology; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000188:drug therapy*; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002220:Carbamazepine