Presentation
Right sided weakness and facial twitching, on background of known focal seizures likely secondary to previous stroke two years ago.
Patient Data
An extensive area of gliosis in the left temporal lobe with associated marked ex vacuo dilatation of the left lateral ventricle. No convincing evidence of an acute infarct or intracranial hemorrhage is identified.
No midline shift or obstructive hydrocephalus. No destructive skull lesion
Case Discussion
The patient presented with right-sided weakness and facial twitching and was previously known to have focal seizures due to stroke 2 years back. The current CT Head showed no acute intracranial hemorrhage and previous areas of left temporal gliosis and ex vacuo dilatation of left lateral ventricle, suggestive of stable appearance. Neurology review was done and the levetiracetam dose was increased in the wards, however, the facial twitches persisted. Sodium valproate was added in conjunction with levetiracetam, and the facial movements were controlled.
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