BMC Psychiatry | |
An uncommon case of random fire-setting behavior associated with Todd paralysis: A case report | |
Jotaro Akiyoshi1  Tomoya Yoshikawa2  Hiroaki Hanada1  Jusen Tsuru1  Yoshihiro Tanaka1  Yoshinobu Ishitobi1  Taiga Ninomiya1  Yoshihiro Maruyama1  Hisae Kohno1  Katsuhiko Morinaga1  Masayuki Kanehisa1  | |
[1] Department of Neuropsychiatry, Oita University Faculty of Medicine, Oita, Hasama-Machi, 879-5593, Japan;FUJIFILM RI Pharma Co., Ltd., Tokyo, 104-0031, Japan | |
关键词: Todd’s paresis; Ictal paralysis; Prolonged seizures; Focal epilepsy; Frontal lobe dysfunction; Lacunar stroke; Arson; Fire setting; | |
Others : 1124299 DOI : 10.1186/1471-244X-12-132 |
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received in 2011-10-07, accepted in 2012-05-23, 发布年份 2012 | |
【 摘 要 】
Background
The association between fire-setting behavior and psychiatric or medical disorders remains poorly understood. Although a link between fire-setting behavior and various organic brain disorders has been established, associations between fire setting and focal brain lesions have not yet been reported. Here, we describe the case of a 24-year-old first time arsonist who suffered Todd’s paralysis prior to the onset of a bizarre and random fire-setting behavior.
Case presentation
A case of a 24-year-old man with a sudden onset of a bizarre and random fire-setting behavior is reported. The man, who had been arrested on felony arson charges, complained of difficulties concentrating and of recent memory disturbances with leg weakness. A video-EEG recording demonstrated a close relationship between the focal motor impairment and a clear-cut epileptic ictal discharge involving the bilateral motor cortical areas. The SPECT result was statistically analyzed by comparing with standard SPECT images obtained from our institute (easy Z-score imaging system; eZIS). eZIS revealed hypoperfusion in cingulate cortex, basal ganglia and hyperperfusion in frontal cortex,. A neuropsychological test battery revealed lower than normal scores for executive function, attention, and memory, consistent with frontal lobe dysfunction.
Conclusion
The fire-setting behavior and Todd’s paralysis, together with an unremarkable performance on tests measuring executive function fifteen months prior, suggested a causal relationship between this organic brain lesion and the fire-setting behavior. The case describes a rare and as yet unreported association between random, impulse-driven fire-setting behavior and damage to the brain and suggests a disconnection of frontal lobe structures as a possible pathogenic mechanism.
【 授权许可】
2012 Kanehisa et al.; licensee BioMed Central Ltd.
【 预 览 】
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