solution

A 33-year-old woman is brought to the Emergency Department from her home. The history of the precipitating event, provided by her neighbor and the woman’s 11-year-old son, indicated the following. The woman was working in her flowerbed and suddenly fell over and, according to her son, “started jerking and twitching and bubbles came out of her mouth.” The examination revealed that the woman was coherent, was oriented, and had no obvious neurological defi-cits. She did say that she has had recurring headaches over the last year or so but has never had a “spell” like this before. T2-weighted MRI reveals the lesion shown below.