We report a 10-year-old boy with mild developmental delay and epilepsy with new events of right back tickling and emotional upset. These initially appeared behavioral, causing postulation of habit behaviors or psychogenic nonepileptic seizures. Several ictal and interictal EEGs were unrevealing. Continuous EEG revealed only poorly localized frontal ictal activity. Given that his clinical symptoms suggested a parietal localization, double-density EEG electrodes were placed to better localize the epileptogenic and symptomatogenic zones. These revealed evolution of left greater than right frontoparietal discharges consistent with seizures at the time of the attacks. Medical management has significantly reduced the patient's seizures.
Keywords: Behavioral stereotypy; CBT, cognitive–behavioral therapy; Frontal epilepsy; MEG, magnetoencephalography; PNES; PNES, psychogenic nonepileptic seizures; Parietal epilepsy; SISCOM, subtracted ictal spect coregistered to MRI brain; SSRI, selective serotonin reuptake inhibitor; Sensory seizures; Tickling; cEEG, continuous electroencephalogram.