Continuous Unilateral Eye Blinking Related to Cerebellar Epilepsy in a Neonate

A 4-month-old baby girl with continuous left eye blinking associated with ipsilateral head rotation since birth was submitted to epilepsy workup (Video 1). MRI revealed a mass in the left superior cerebellar peduncle (Figure, A) and PET/CT showed hypermetabolism in the lesion and occipital lobes. Superficial EEG was normal. During surgical resection, an electrode was placed directly in the lesion and seizure activity was registered originating from it (Figure, C). Histopathology confirmed the diagnosis of cerebellar gangliomatous hamartoma (Figure, D). She was seizure-free after surgery. Cerebellar lesions can rarely cause epilepsy presenting with hemifacial spasm; possible mechanisms are interruption of the dentorubrothalamic tract and facial nucleus compression.1,2

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