Capgras Syndrome and Unilateral Spatial Neglect in Nonconvulsive Status Epilepticus

L Christine Turtzo,Rafael H Llinas,Jonathan T Kleinman

doi:10.1155/2008/935967

Abstract

Nonconvulsive status epilepticus can manifest as personality changes and psychosis. We report an 87-year-old right-handed male presenting with both Capgras syndrome and severe unilateral spatial neglect during nonconvulsive status epilepticus. After treatment of his seizures, his Capgras syndrome and hemispatial neglect resolved. This case illustrates a report of the confluence of Capgras syndrome and documented hemispatial neglect in nonconvulsive status epilepticus only reported once previously [1].

Highlights

Nonconvulsive status epilepticus (NCSE) is defined as ongoing or intermittent electroencephalographical seizure activity for a minimum of 30 minutes, associated with cognitive or behavioral changes, in the absence of convulsive clinical manifestations [2]
We describe an 87-year-old patient who manifested concurrent hemispatial neglect and Capgras syndrome in conjunction with NCSE
The patient’s presentation initially appeared most consistent with a right-hemispheric stroke, given the predominance of hemispatial neglect, there was no evidence of infarct or other intracranial lesion by neuroimaging

Summary

Introduction

Nonconvulsive status epilepticus (NCSE) is defined as ongoing or intermittent electroencephalographical seizure activity for a minimum of 30 minutes, associated with cognitive or behavioral changes, in the absence of convulsive clinical manifestations [2]. The nonspecific manifestations of NCSE, which may include confusion, behavioral changes, personality change, and psychosis, as well as the focal neurological presentation such as aphasia [3,4] make EEG findings crucial for its diagnosis when suspected [5,6,7]. Considerable debate exists regarding the diagnosis and prognosis of NCSE, elderly patients, especially those with comorbid medical conditions, appear to have higher mortality associated with NCSE [2]. In this case report, we describe an 87-year-old patient who manifested concurrent hemispatial neglect and Capgras syndrome in conjunction with NCSE

Case report

Discussion