RT Journal Article SR Electronic T1 Mesial bifrontal stroke presenting as isolated spontaneous confabulations JF Practical Neurology JO Pract Neurol FD BMJ Publishing Group Ltd SP practneurol-2020-002518 DO 10.1136/practneurol-2020-002518 A1 Vardan Nersesjan A1 Henrik Gutte Bogwardt A1 Daniel Kondziella YR 2020 UL http://pn.bmj.com/content/early/2020/07/06/practneurol-2020-002518.abstract AB A 52-year-old man with paroxysmal atrial fibrillation presented with spontaneous confabulation, working memory deficits, and frontal release signs. MR scan of brain showed bifrontal mesial ischaemic strokes and angiography demonstrated that both anterior cerebral arteries were supplied by the left internal carotid artery. Isolated spontaneous confabulation is a rare presentation of stroke and may be associated with orbitofrontal cortex lesions. Interestingly, functional imaging during rapid-eye-movement sleep may show bilateral medial frontal lobe hypometabolism, suggesting anatomical overlap between dreaming and the bizarre content of this patient’s spontaneous confabulation.