Frontale epilepsie of een psychogene aandoening?

Een goede anamnese is het belangrijkst
Casuïstiek
22-02-2021
Karen Foeken, Iris Winter en Rob P.W. Rouhl

Frontal lobe epilepsy or a psychogenic disorder? The importance of taking a good patient history

Background

Frontal lobe epilepsy (FE) is a diagnosis which can be easily missed due to the variety in symptoms. The symptoms depend on the location of the epileptical activity in the frontal lobe.

Case description

A 48-year-old man of Moroccan descent is diagnosed with frontal epilepsy, but this diagnosis is rejected based on the 24-hours EEG. Instead he is diagnosed with psychogenic non-epileptic seizures (PNES). Upon this diagnosis, he develops reactive depressive symptoms and he is referred to the psychiatrist. However, based on the clinical presentation the diagnosis PNES is overruled and replaced with frontal lobe epilepsy. The patient recovers when he is treated with valproic acid.

Conclusion

The article describes the symptoms of FE and those of PNES. This case description demonstrates the difficulties and illustrates the importance of a good history when diagnosing FE.

Conflict of interest and financial support: none declared.