Impairment of Parietal Cortical Functions Associated with Episodic Prolonged Spike‐and‐Wave Discharges

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Abstract
A case of a 16-year-old who showed selective impairment of higher cortical functions and very slight lowering of initiative activity without overt disturbance of consciousness, during prolonged generalized spike-and-wave discharges with a parietal predominance is reported. Neuropsychological investigations during the episode revealed a disturbance of parietal cortical functions, such as constructional apraxia, ideational or ideomotor apraxia, finger agnosia, acalculia, right-left disorientation, disturbance of visual-spatial orientation, and agraphia. The transient impairment of parietal cortical functions associated with the parietal-dominant spike-and-wave discharges was suggested as a principal pathophysiology of the clinical picture. Emphasis is placed on the importance of neuropsychological assessment in such a case.