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EEG findings were suggestive of burst suppression pattern [Figure 2]. Magnetic resonance imaging (MRI) showed a hyper intense lesion in the subcutaneous plane on the left side of face suggestive of a lipoma on axial T1-weighted imaging (T1-WI) [Figure 3a]. Axial T1-WI also demonstrated a hyper intense lesion in the ambient cistern on the right side suggestive of lipoma [Figure 3b]. Axial T2-WI demonstrated left-sided hemimegalencephaly with an enlarged hemisphere Selleck AZD4547 and midline shift of the left occipital lobe [Figure 3c]. Axial fluid-attenuated inversion recovery image showed asymmetric cerebellum with abnormal folia [Figure 4a]. Computed tomography brain showed left hemimegalencapahly and intracranial calcification in the right ambient cistern demonstrating a calcified lipoma [Figure 4b]. Figure 2 Electroencephalogram showing multifocal bursts of spikes, sharp waves, and poly-spikes followed by suppression lasting for 3�C4 s suggestive of burst suppression pattern Figure 3 (a) Axial T1-weighted imaging (T1-WI) demonstrating a hyperintense lesion in the subcutaneous plane on the left side of face suggestive of a lipoma. (b) Axial T1-WI www.selleckchem.com/products/Cisplatin.html demonstrating a hyperintense lesion in the ambient cistern on the right side suggestive ... Figure 4 (a) Axial fluid-attenuated inversion recovery image showing asymmetric cerebellum with abnormal folia. (b) Computed tomography scan image demonstrating a calcified lipoma in the ambient cistern on right side Child was treated with injection adrenocorticotropic hormone 24 IU daily for 2 weeks and valproate with partial control of spasms. Discussion Partial motor, or partial complex seizures are the most frequent types of epilepsy in hemimegalencephaly and are associated with infantile spasms in 50% of patients. Developmental delay is often early and severe, though variations are often present.[2] Our child had global developmental delay. Anomalies of cortical development including polymicrogyria, pachygyria, and gray-matter heterotopias are always seen in the affected portions of the hemisphere, INPP5D but can be seen in the ��unaffected�� hemisphere as well.[2] Ohtahara syndrome is a severe epileptic syndrome that is characterized by early onset (