Teaching NeuroImage: Pseudo–Figure-of-4 Sign

Abstract

A 37-year-old right-handed man with spastic quadriparetic cerebral palsy, congenital hydrocephalus, and anxiety was admitted for seizure characterization with video-EEG monitoring. Neurologic examination demonstrated marked upper extremity spasticity and left elbow flexion contracture. Three habitual focal to bilateral tonic-clonic seizures (Figure 1) were recorded on EEG (Figure 2).