Pediatric epilepsy patient with a likely frontal lobe focus exhibiting higher brain dysfunction despite seizure control : A case report

DOI
  • Morooka Teruko
    Division of Medical Support, Okayama University Hospital, Okayama
  • Oka Makio
    National Center for Child Health and Development, Tokyo Department of Child Neurology, Okayama University Hospital, Okayama
  • Ogino Tatsuya
    Fukuyama Support Center of Development and Care for Children, Fukuyama, Hiroshima
  • Yoshinaga Harumi
    National Hospital Organization Minami-Okayama Medical Center, Tokubo-gun, Okayama
  • Kobayashi Katsuhiro
    Department of Child Neurology, Okayama University Hospital, Okayama

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Other Title
  • 発作抑制後も高次脳機能障害が残存した前頭葉焦点と考えられるてんかんの1例

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Abstract

<p>  Although patients with frontal lobe epilepsy are reported to exhibit cognitive dysfunction, no patients have been followed-up in regard to their detailed cognitive functioning for a long period after seizure termination. Here, we report on a Japanese boy who presented with cluster seizures at 12 years, 8 months of age, and was diagnosed with epilepsy with a likely frontal lobe focus. Approximately one year from the onset, his seizures were almost controlled. Another year later, he regained general intelligence and epileptic discharges disappeared from EEG. However, personality and behavior changes were observed following cluster seizures and he scored low on the Boston Qualitative Scoring System (BQSS) for the Rey-Osterrieth Complex Figure test. Approximately four years after onset, at 16 years, 8 months of age, his behaviors had largely recovered, with improvement of BQSS scores to the normal range. The BQSS is useful to evaluate visuoconstructional ability, visual memory performance, and in particular, the planning ability of frontal lobe functions based on the order in which elements are drawn. Patients with frontal lobe dysfunctions are known to perform poorly in drawing strategy and, therefore, this patient’s poor drawing strategy in the Rey-Osterrieth Complex Figure indicated by the low BQSS scores may be related to frontal lobe dysfunctions, poor planning ability in particular, associated with personality and behavior changes after cluster seizures.</p>

Journal

  • NO TO HATTATSU

    NO TO HATTATSU 55 (5), 356-362, 2023

    The Japanese Society of Child Neurology

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