An uncommon case of random fire-setting behavior associated with Todd paralysis: A case report

BMC Psychiatry

Case Report

Katsuhiko Morinaga¹  Masayuki Kanehisa¹  Hisae Kohno¹  Hiroaki Hanada¹  Jusen Tsuru¹  Taiga Ninomiya¹  Yoshihiro Maruyama¹  Yoshinobu Ishitobi¹  Yoshihiro Tanaka¹  Jotaro Akiyoshi¹  Tomoya Yoshikawa² 

[1] Department of Neuropsychiatry, Oita University Faculty of Medicine, 879-5593, Hasama-Machi, Oita, Japan;FUJIFILM RI Pharma Co., Ltd., 104-0031, Tokyo, Japan;

关键词: Fire setting;    Arson;    Lacunar stroke;    Frontal lobe dysfunction;    Focal epilepsy;    Prolonged seizures;    Ictal paralysis;    Todd’s paresis;   

DOI  :  10.1186/1471-244X-12-132

 received in 2011-10-07, accepted in 2012-05-23,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundThe 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 presentationA 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.ConclusionThe 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】

Unknown   
© Kanehisa et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.