Abstract
This 13-year-old girl with a normal perinatal course presented with almost daily right focal motor seizures with or without generalization since about 6 years of age. She took four antiepileptic drugs (phenytoin, valproate, levetiracetam, and clobazam). Along with seizures, she had progressive right spastic hemiparesis affecting her right arm dexterity and ambulation as well as cognitive impairment. On examination, she had spastic dysarthriawith right spastic hemiparesis. Brain magnetic resonance imaging (MRI) showed left cerebral and right cerebellar hemispheric atrophy with fluid-attenuated inversion recovery showing left frontoparietal cortical hyperintensities (Figure). Electroencephalograph showed left hemispheric slowing of background rhythm in the theta range. Cerebrospinal fluid analysis was normal. She received 5 days course of
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