A 7-year-old child with absence seizures and a 3-Hz generalized and occasional focal, spike-and-wave EEG pattern, responsive to treatment with valproic acid, had an MRI with periventricular nodular heterotopias, primarily right sided. The neurologic examination was normal. [1]

COMMENT. Focal abnormalities in an otherwise typical and generalized EEG pattern for childhood absence epilepsy prompted an MRI in this case which uncovered the unexpected cerebral migration lesion.