Apy Liu, K Oakhill, GCF Chan, BHY Chung

A 5-month old boy presented with twitching of left sided angle of mouth for one week. The baby was born at 38 weeks with birth weight of 3.8 kg by elective Caesarean Section for maternal preference. Delivery was uneventful as was his neonatal course. Patient's parents were non-consanguineous Chinese and there was no family history of seizure, developmental delay, intellectual disability or metabolic disease. Other than the twitching, the child remained afebrile, active with good appetite.

Physical examination revealed skin lesions as depicted in Figure A. Electroencephalogram showed focal spike wave discharges. Magnetic Resonance Imaging of the brain was subsequently performed (Figure B).

Answer to "Clinical Quiz" on Pages 77-79

N.B. The Editors invite contributions of illustrative clinical cases or materials to this section of the journal.