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Behavioural Neurology
Volume 7 (1994), Issue 3-4, Pages 153-158

Psychiatric Symptoms in Patients with Focal cortical Degeneration

R. M. Lawrence, M. A. Ronca, P. Tyrrell, and M. N. Rossor

National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK

Received 17 February 1994; Accepted 20 October 1994

Copyright © 1994 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The psychiatric phenomenology exhibited by a mixed group of patients with focal cortical degeneration (FCD) is described. The diagnosis of FCD was made in the presence of a slowly progressive focal neuropsychological deficit without evidence of infarct or neoplasm. Localized or asymmetric atrophy was present on neuroimaging (CT or MRI) and positron emission tomography demonstrated focal hypometabolism or in those assessed later in the disease an area of maximal hypometabolism which correlated with the neuropsychological deficit. FCD patients exhibited prominent obsessive–compulsive behaviour. Obsessive–compulsive features were often repetitive, stereotyped and bizarre and occurred in association with frontal and left temporal atrophy and hypometabolism and were absent in those with predominant posterior cortical pathology.