Psychosis as a manifestation of frontal lobe epilepsy

Aimee F. Luat, Eishi Asano, Robert Rothermel, Sandeep Sood, Harry T. Chugani

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


A 7-year-old girl presented with a cluster of seizures occurring in one day and followed by the development of paranoid delusions. Her electroencephalogram (EEG) revealed a psychomotor variant. Cranial MRI was normal, but the 2-deoxy-2-[18F]fluoro-D-glucose (FDG) positron emission tomography (PET) scan showed hypometabolism in the left inferior frontal cortex. Her psychotic symptoms occurred episodically. Three years later, she developed hypermotor seizures associated with a fearful look. Video/EEG monitoring captured seizures of left frontotemporal onset. Her seizures became drug resistant and she underwent epilepsy surgery. Intracranial electrocorticography captured spontaneous and electrically induced seizures with onset in the left inferior frontal region, which was resected. She became seizure-free and her psychosis resolved. This case illustrates that frontal lobe epilepsy can present solely with psychotic symptoms, which may delay the diagnosis of epilepsy. We suggest that these cases may be underdiagnosed. When epilepsy is suspected and if MRI fails to demonstrate an abnormality, FDG PET scanning and video/EEG monitoring should be considered.

Original languageEnglish
Pages (from-to)200-204
Number of pages5
JournalEpilepsy and Behavior
Issue number1
StatePublished - Jan 2008


  • 2-deoxy-2-[F]fluoro-D-glucose positron emission tomography scan
  • Cortical stimulation
  • Frontal lobe epilepsy
  • Psychosis


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