Epileptic activity is an underdiagnosed cause that can determine a disruption ofmemory and cognitive performance, leading an incorrect diagnosis of dementia. Wereport a 68-year-old man, referred with a 5-year history of subtle behavioral changesand a subjective memory impairment, who was admitted to our department because ofrecurrent episodes of confusional state lasting from 1 week. Neuropsychologicalevaluation demonstrated a marked impairment of all cognitive domains examined.Electroencephalogram (EEG) recording showed frequent almost continuous sharpwaves localized on the bilateral posterior temporal regions with mild right side pre-dominance. Treatment with phenytoin reversed his cognitive dysfunction and beha-vioral disturbances. We presume that ictal temporal lobe epileptiform activity is thecause of his confusional episodes and cognitive dysfunction, showing an electroclinicalpicture of complex partial status epilepticus. However, we hypothesize that theinterictal discharges and ictal and postictal effects of subclinical seizures could beinvolved in the behavioral changes and memory impairment complained by ourpatient in the last years
Temporal lobe epileptic activity mimicking dementia: A case report
Koch GSecondo
;
2005
Abstract
Epileptic activity is an underdiagnosed cause that can determine a disruption ofmemory and cognitive performance, leading an incorrect diagnosis of dementia. Wereport a 68-year-old man, referred with a 5-year history of subtle behavioral changesand a subjective memory impairment, who was admitted to our department because ofrecurrent episodes of confusional state lasting from 1 week. Neuropsychologicalevaluation demonstrated a marked impairment of all cognitive domains examined.Electroencephalogram (EEG) recording showed frequent almost continuous sharpwaves localized on the bilateral posterior temporal regions with mild right side pre-dominance. Treatment with phenytoin reversed his cognitive dysfunction and beha-vioral disturbances. We presume that ictal temporal lobe epileptiform activity is thecause of his confusional episodes and cognitive dysfunction, showing an electroclinicalpicture of complex partial status epilepticus. However, we hypothesize that theinterictal discharges and ictal and postictal effects of subclinical seizures could beinvolved in the behavioral changes and memory impairment complained by ourpatient in the last yearsI documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
