A 19-year-old male had drug-resistant epilepsy and recurrent focal and generalized seizures. Trauma was reported in early childhood after he was struck by an automobile at the age of 5. This resulted in significant traumatic brain injury and cognitive impairment. In addition, daily, nocturnally predominant, recurrent seizures became noted that were refractory to multiple AEDs. MRI of the brain revealed evidence of prior trauma (detail). EEG demonstrated diffuse slowing. Video EEG monitoring was ultimately performed though a referral for epilepsy surgery evaluation was not pursued (Fig. 38.1).
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