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case_images: EEG during initial admission at 4-month of age showing interictal epileptiform abnormalities (top) and ictal electro-decrement correlated with epileptic spasms (bottom).
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case_images: Video EEG during admission confirmed evolving hypsarrhythmia (a BASED score of 3) and a diagnosis of infantile spasms (Fig. 1).
case_images: Initial brain MRI without contrast showing diffuse lissencephaly with scattered shallow gyri predominately in the frontal region (denoted by arrows). Note the normal ventricular sizing on the T1 sequence and lack of intracranial calcifications on the SWI sequence.
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case_images: ICU stay. Investigative work-up included an MRI of the brain which revealed type 1 lissencephaly (Fig. 2). However, there was no intracranial calcification appreciated on the brain MRI to suggest a symptomatic cCMV infection (Fig. 2).
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case_images: The most recent 6-hour video EEG at age of 3-year and 3-month revealing interictal high amplitude slow spike-wave epileptiform discharges (top) and one electro-clinical tonic seizure (bottom).
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case_images: A follow-up EEG at age of 3-year and 3-month captured only one tonic seizure during a 6-hour recording and still showed abundant generalized versus bilateral periodic epileptiform discharges (Fig. 3).