Case 34-2014: A 7-Year-Old Boy with Focal Seizures and Progressive Weakness

A 7-year-old boy was evaluated because of focal seizures, twitching of the right arm and the right side of the face, and progressive weakness. Imaging revealed progressive left cortical atrophy and a focal lesion in the left parietal cortex. A diagnostic procedure was performed. Presentation of Case Dr. Michael Ho (Neurology): A 7-year-old boy was evaluated in an outpatient clinic at this hospital because of focal seizures and progressive right-sided weakness. The patient had been well until 18 months earlier, when intermittent shaking of his right hand developed, which quickly progressed to involve the entire right arm. Evaluation at another hospital included electroencephalography (EEG) that revealed frequent left-sided discharges, magnetic resonance imaging (MRI) of the head that revealed no clear atrophy but a lesion in the left motor strip, and a lumbar puncture with normal results on cerebrospinal fluid analysis. A diagnosis of focal . . .