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Focal hemifacial clonic seizures of rolandic epilepsy

This video-EEG of an 8-year-old boy was recorded shortly after awakening. It shows a typical left-sided hemifacial clonic seizure that begins with a tonic deviation of the tongue and mouth followed by hemifacial clonic jerks, hypersalivation, drooling, and inability to speak during the ictal phase. There is left postictal paresis. On EEG, note the prominent interictal right centrotemporal biphasic spike-wave activity prior to and after the termination of the seizure. The ictal discharge consists of focal low-amplitude fast activity localized in the right rolandic regions. (Courtesy of Jacques Motte, American Memorial Hospital, Reims, France. Used with permission: Panayiotopoulos CP, Benbadis SR, Sisodiya SM. Focal epilepsies: seizures and syndromes. Oxford: Medicinae, 2008a:1-256.)