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Figure 3: Eleven-year-old girl with perinatal insult and daily refractory seizures manifesting as visual aura progressing to tonic asymmetric contractions (right more than left) with falls and left occipitoposterior temporoparietal gliosis on MRI [Case 2-Table 1]. (a and b) Interictal EEG showing generalized epileptiform discharges with attenuation over left posterior head regions. (c) VEEG captured left hemispheric complex partial seizures with generalized attenuation at seizure onset followed by 3-4 Hz generalized spike and waves. Postical EEG showed diffuse slowing with increased attenuation over the left posterior head region. She was uncooperative for visual field assessment. (d) Functional MRI (f-MRI) for visual fields (checker box-D1 and cartoons-D2) showed BOLD activation only in the right occipital area. Language f-MRI (D3-sentence completion and D4-verb generation) showed language lateralized to the right hemisphere. Motor fi nger tapping BOLD activation matched anatomical hand area (D5). She underwent a left posterior quadrant disconnection to become seizure free (e-postoperative CT). Postoperative EEG showing normal sleep patterns without epileptiform discharges (f)

Figure 3: Eleven-year-old girl with perinatal insult and daily refractory seizures manifesting as visual aura progressing to tonic asymmetric contractions (right more than left) with falls and left occipitoposterior temporoparietal gliosis on MRI [Case 2-Table 1]. (a and b) Interictal EEG showing generalized epileptiform discharges with attenuation over left posterior head regions. (c) VEEG captured left hemispheric complex partial seizures with generalized attenuation at seizure onset followed by 3-4 Hz generalized spike and waves. Postical EEG showed diffuse slowing with increased attenuation over the left posterior head region. She was uncooperative for visual field assessment. (d) Functional MRI (f-MRI) for visual fields (checker box-D1 and cartoons-D2) showed BOLD activation only in the right occipital area. Language f-MRI (D3-sentence
completion and D4-verb generation) showed language lateralized to the right hemisphere. Motor fi nger tapping BOLD activation matched anatomical hand area (D5). She underwent a left posterior quadrant disconnection to become seizure free (e-postoperative CT). Postoperative EEG showing normal sleep patterns without epileptiform discharges (f)