(A) Seizure semiology. Upper panel: facial expression of our patient with ictal pouting and eyes open; lower panel: ictal pouting with closed eyes, clenching of the right fist, and dystonic posturing of the left hand. (B) MRI scan of the brain in (from top to bottom) axial, coronal, and sagittal sections showing the suspected dysplastic lesion in the anterior part of the left subcentral lobe. (C) Interictal EEG findings showing epileptic discharges in the left central region. (D) Ictal findings revealing initial ictal discharge starting in the left central region.