A young female with left sided focal seizure.

A 23 years old female presented with recurrent episode of left hemiparesis for 6 months. Each episode lasted for 10 to 20 min at interval of 15 to 20 days. These episodes of weakness were not associated with any seizure like activity, unconsciousness or other focal neurological deficit. Three days back patient had recurrent left sided focal motor seizure with secondary generalization. She had past history of seizure at age of six months, since then she was asymptomatic till six month back. Physical examination revealed left sided face arm leg weakness and a left extensor planter response. A Portwine stain present on the right side of face in the region of ophthalmic and maxillary division of trigeminal nerve (Fig. 1). The examination of right eye revealed megalocornea, deep anterior chamber, increased intraocular pressure, glaucomatous optic atrophy with 90% cupping and choroidal hemangiomas. Left eye was normal on examination. Baseline investigation including hematology, serum biochemical and coagulation profile were within normal limits. computerized tomography (cT) Scan of cranium showed gyral calcification in parieto-occipital lobe of right hemisphere (Trolly-Track appearance), dilated and tortuous vessels in ventricular system with contrast enhancement (Fig. 2A & 2B). The case was diagnosed as Sturge Weber syndrome.