Strange Case of Non-Epileptic Attacks of Speechlessness – A Single Case Study around an Understandable Misdiagnosis
American Journal of Psychiatry and Neuroscience
Volume 3, Issue 1, January 2015, Pages: 1-7
Received: Nov. 22, 2014; Accepted: Jan. 5, 2015; Published: Jan. 23, 2015
Views 2207      Downloads 98
Authors
Erich Kasten, MSH Medical School Hamburg, University of Applied Sciences and Medical University, Am Kaiserkai 1, D-20457 Hamburg, Germany
Nadine Sasse, Department of Medical Psychology and Medical Sociology, University Medical Center, Georg-August-University, Göttingen, Germany
Article Tools
Follow on us
Abstract
In this single-case study, after a brain-damage, for a young female patient the following diagnoses were supposed in a period of nearly 20 years: depression, posttraumatic stress disorder, dissociative identity disorder, narcissism personality disorder, schizotypic personality disorder with pronounced abnormal behaviour, experiences of insufficiency with problems of segregation, psycho-neurotic symptoms with serious fluctuations of mood, motor inhibition, organic psycho-syndrome after brain contusion, emotional blockade with separation of premature parts of the self, non-epilepsy and, in contrast, complex-focal epilepsy. The article describes the history of the female patient and discusses the factors, why the correct diagnosis was misunderstood so easily for other disturbances.
Keywords
Misdiagnosis, Epilepsy, Speech Disorder, Face-Paralysis, Partial Paralysis, Dissociative Disturbance, Cataplexia, Narcolepsy, Speechlessness, Mutism
To cite this article
Erich Kasten, Nadine Sasse, Strange Case of Non-Epileptic Attacks of Speechlessness – A Single Case Study around an Understandable Misdiagnosis, American Journal of Psychiatry and Neuroscience. Vol. 3, No. 1, 2015, pp. 1-7. doi: 10.11648/j.ajpn.20150301.11
References
[1]
Aldrich M. Narcolepsy. Neurology 1992; 42(6): 34 - 43
[2]
Aldrich M. Diagnostic aspects of narcolepsy. Neurology 1998; 50 (1): 2 – 7
[3]
Alloway CE, Ogilvie RD, Shapiro CM. EEG spectral analysis of the sleep-onset period in narcoleptics and normal sleepers. Sleep. 1999; 22(2):191-203
[4]
Bassetti C, Gugger M, Bischof M, Mathis J, Sturzenegger C, Werth E, Radanov B, Ripley B, Nishino S, Mignot E. The narcoleptic borderland: a multimodal diagnostic approach including cerebrospinal fluid levels of hypocretin-1 (orexin A). Sleep Med. 2003; 4(1): 7-12.
[5]
Bäumler G. Lern- und Gedächtnistest LGT-3. Göttingen: Hogrefe, 1974.
[6]
Bierbrauer J, Heidenreich T Hilwerling L, von Nessen S, Fey P, Kögel P, Pflug B. Narkolepsie. Nervenarzt 2000; 71:807 – 812.
[7]
Billiard M, Carlander B. Troubles de l'éveil: première partie troubles primaires de l'éveil. Rev Neurol (Paris). 1998 Feb;154(2):111-29
[8]
Bleuler E.: Lehrbuch der Psychiatrie. Berlin: Springer-Verlag, 1916
[9]
Brickenkamp R. Test d2 – Aufmerksamkeits-Belastungs-Test. Göttingen: Hogrefe, 1981
[10]
Broughton R, Low R, Valley V, Da Costa B, Liddiard S. Auditory evoked potentials compared to performance measures and EEG in assessing excessive daytime sleepiness in Narcolepsy-Cataplexia. Electroencephalogr Clin Neurophysiol. 1982 Nov;54(5):579-82
[11]
Buskova J, Vaneckova M, Sonka K, Seidl Z, Nevsimalova S. Reduced hypothalamic gray matter in Narcolepsy with Cataplexia. Neuro Endocrinol Lett. 2006; 27(6)
[12]
Chemelli RM, Willie JT, Sinton CM, Elmquist JK, Scammell T, Lee C, Richardson JA, Williams SC, Xiong Y, Kisanuki Y, Fitch TE, Nakazato M, Hammer RE, Saper CB, Yanagisawa M. Narcolepsy in orexin knockout mice: molecular genetics of sleep regulation. Cell 1999; 98(4): 437 - 451.
[13]
Daniels L. Narcolepsy. Medicine 1934; 13: 1 – 122
[14]
Dauvilliers Y, Baumann C, Maly F, Billiard M, Bassetti C. CSF hypocretin-1 levels in narcolepsy, Kleine-Levin syndrome, other hypersomnias and neurological conditions. J. Neurol. Neurosurg. and Psychiatry 2003; 74, 1667–1673.
[15]
Dornblüth O. Kompendium der Psychiatrie. Verlag Veit & Comp., 1894.
[16]
Dornblüth O. Klinisches Wörterbuch. 13. Aufl., 1927
[17]
Ebel H, Albermissen C. Psychogene Bewegungsstörungen. Psychoneuro 2005; 31: 388-391
[18]
Fahrenberg J, Hampel R, Selg H. Das Freiburger Persönlichkeitsinventar – FPI-R. Göttingen: Hogrefe, 1983
[19]
Gelineau J. De la narcolepsie. Gazette des Hopitaux (Paris) 1880; 53: 626-628.
[20]
Guilleminault C, Brooks SN. Excessive daytime sleepiness: A challenge for the practising neurologist, Brain 2001; 124(8): 1482 - 1491
[21]
Guilleminault, C, Partinen M, Quera-Salva MA, Hayes B, Dement WC, Nino-Murcia G. Determinants of daytime sleepiness in obstructive sleep apnea. Chest 1988; 94: 32–37
[22]
Guilleminault C, Pelayo R. Narcolepsy in prepubertal children. Ann. Neurol. 1998; 43: 135–142.
[23]
Hadjiyannakis K, Ogilvie RD, Alloway CE, Shapiro C. FFT analysis of EEG during stage 2-to-REM transitions in narcoleptic patients and normal sleepers. Electroencephalogr Clin Neurophysiol. 1997 Nov;103(5):543-53
[24]
Hohagen F, Schönbrunn E. Die Narkolepsie und andere Formen der Hypersomnie. In: M. Berger (Hrsg.): Handbuch des normalen und gestörten Schlafs. Springer-Verlag, Berlin-Heidelberg-New York 1992.
[25]
Honda Y, Juji T, Matsuki K, Naohara T, Satake M, Inoko H, Someya T, Harada S, Doi Y. HLA-DR2 and Dw2 in narcolepsy and in other disorders of excessive somnolence without Cataplexia. Sleep. 1986; 9(1/2):133–142.
[26]
Hublin, C, Partinen M, Kaprio J, Koskenvuo M, Guilleminault C. Epidemiology of narcolepsy. Sleep 1994; 17: 7–12.
[27]
Kasten, E., Gothe, J. & Müller, I. (2003) Psychische Störungen nach Hirnschädigung. Psychomed 15/4, S. 214- 221
[28]
Khatami RY, Maret S, Werth E, Rétey J, Schmid D, Maly F, Bassetti C. A monozygotic twin pair concorsant for narcolepsy-Cataplexia without any detectable abnormality in the hypocretin (orexin) pathway. Lancet 2004; 363: 1199–1200.
[29]
Kobayashi Y, Miyamoto M, Miyamoto T, Yamazaki K, Hirata K, Kanbayashi T, Shimizu T. [Nacrolepsy manifesting initially as Cataplexia and sleep paralysis: usefulness of CSF hypocretin-1 examination for early diagnosis] Rinsho Shinkeigaku. 2002; 42(3): 233-236.
[30]
Lin L, Faraco J, Li R, Kadotani H, Rogers W, Lin X, Qiu X, de Jong PJ, Nishino S, Mignot E.The sleep disorder canine narcolepsy is caused by a mutation in the hypocretin (orexin) receptor 2 gene. Cell 1999; 98: 365-76
[31]
Linert GA, Schuler H. Revidierter Allgemeiner Büroarbeitestst – ABAT-R. Göttingen: Hogrefe, 1994.
[32]
Löwenfeld I. Über Narkolepsie. Münchner Medizinische Wochenschrift 1902; 49: 1041
[33]
Macleod S, Ferrie C, Zuberi SM. Symptoms of narcolepsy in children misinterpreted as epilepsy. Epileptic Disord. 2005 Mar;7(1):13-17
[34]
Mayer, G. Narkolepsie. Berlin: Blackwell, 2000.
[35]
Mayer G. Neurophysiologie der Cataplexie. Nervenarzt 2005; 76:1464–1469
[36]
Meier-Ewert K. Tagesschläfrigkeit. Ursachen, Differentialdiagnose, Therapie. Weinheim: VCH, Edition Medizin,1989.
[37]
Mignot E. Genetic and familial aspects of narcolepsy. Neurology 1998; 50: (1) S16-S22
[38]
Mignot E. Human and animal genetics of sleep and sleep disorders. In: Chokroverty S, (Ed.) Sleep disorders medicine. Boston: Butterworth Heinemann, 1999a.
[39]
Mignot E., Young T, Lin L, Finn L. Nocturnal sleep and daytime sleepiness in normal subjects with HLA-DQB1*0602. Sleep 1999b; 22: 347–352.
[40]
Mignot E, Lin X, Arrigoni J, Macaubas C, Olive F, Hallmayer J, Underhill P, Guilleminault C, Dement WC, Grumet FC. DQB1*0602 and DQA1*0102 (DQ1) are better markers than DR2 for narcolepsy in Caucasian and black Americans. Sleep 1994; 17 (8): 60–67.
[41]
Mitler MM. Evaluation of treatment with stimulants in narcolepsy. Sleep 1994; 17: 103–106.
[42]
Mitler MM, Hajdukovic R. Relative efficacy of drugs for the treatment of sleepiness in narcolepsy. Sleep 1991; 14: 218–220.
[43]
Nishino S, Mignot E. Pharmacological aspects of human and canine narcolepsy. Prog Neurobiol 1997; 52: 2778.
[44]
Nishino S, Ripley B, Overeem S, Lammers GJ, Mignot E. Hypocretin (orexin) deficiency in human narcolepsy. Lancet 2000; 355: 39–40
[45]
Oka Y, Inoue Y, Kanbayashi T, Kuroda K, Miyamoto M, Miyamoto T, Ikeda A, Shimizu T, Hishikawa Y, Shibasaki H. Narcolepsy without Cataplexia: 2 subtypes based on CSF hypocretin-1/orexin-A findings. Sleep. 2006; 29(11): 1439-1443
[46]
Poirier G., Montplaisir J, Decary F, Momege D, Lebrun A. HLA antigens in narcolepsy and idiopathic central nervous system hypersomnolence. Sleep 9, 153–158.
[47]
Prizmetal, M., Bloomberg, W. 1935. The use of benzedrine for the treatment. of narcolepsy. JAMA 1986; 105: 2051-2054
[48]
Ripley B, Overeem S, Fujiki N, Nevsimalova S, Uchino M, Yesavage J, Di Monte D, Dohi K, Melberg A, Lammers GJ, Nishida Y, Roelandse FW, Hungs M, Mignot E, Nishino S. CSF hypocretin/orexin levels in narcolepsy and other neurological conditions. Neurology 2001; 57: 2253–2258.
[49]
Roth B. Über das Elektrencephalogramm bei der Narkolepsie-Cataplexie. European Archives of Psychiatry and Clinical Neuroscience 1962; 203( 4)
[50]
Sakurai, T, Amemiya A, Ishii M, Matsuzaki I, Chemelli RM, Tanaka H, Williams SC, Richardson JA, Kozlowski GP, Wilson S, Arch JRS, Buckingham RE, Haynes AC, Carr SA, Annan RS, McNulty DE, Liu WS, Terrett JA, Elshourbagy NA, Bergsma DJ, Yanagisawa M. Orexins and Orexin Receptors: A Family of Hypothalamic Neuropeptides and G Protein-Coupled Receptors that Regulate Feeding. Behavior Cell 1998; 92: 573-585
[51]
Schenck CH, Boyd JL, Mahowald MW. A parasomnia overlap disorder involving sleepwalking, sleep terrors, and REM sleep behavior disorder in 33 polysomnographically confirmed cases. Sleep. 1997 Nov; 20(11):972-81.
[52]
Siegel JM, Moore R, Thannickal T, Nienhuis R. A brief history of hypocretin/orexin and narcolepsy. Neuropsycho- pharmacology. 2001; 25(5): S14-20
[53]
Sturzenegger C, Bassetti C. The clinical spectrum of narcolepsy with Cataplexia: A reappraisal. J. Sleep Res. 2004; 13: 1–13.
[54]
Vaughn BV, D'Cruz OF. Carbamazepine as a treatment for Cataplexia. Sleep. 1996; 19(2): 101-103
[55]
Vogel G. Study in psychophysiology of dreams. III. The dream of narcolepsy. Archives of General Psychiatry 1960; 3: 421-428
[56]
Westphal T. Eigentümliche mit Einschlafen verbundene Anfälle. Archiv für Psychiatrie und Nervenkrankheiten 1877: 7
[57]
Wiegand MH, von Spreti F, Förstl H. Schlaf & Traum – Neurobiologie, Psychologie, Therapie. Stuttgart: Schattauer, 2006.
[58]
Zeman A., Douglas N, Aylward, R. Clinical review, Lesson of the week, Narcolepsy mistaken for epilepsy, BMJ 2001;322:216-218
ADDRESS
Science Publishing Group
548 FASHION AVENUE
NEW YORK, NY 10018
U.S.A.
Tel: (001)347-688-8931