Fig. 1.

Box 1. Brain MRI features: axial (a) and coronal (b) T2 weighted images and axial (c) and coronal (d) Flair images show hyperintensity and mild expansion of both medial temporal lobes. The study of medial temporal lobes with diffusion weighted images demonstrates high signal in DWI b1000 (e) and no diffusivity restriction in ADC maps (f), denoting the presence of vasogenic edema. T1 weighted images acquired before (g) and after (h) contrast administration demonstrate no contrast enhancement. FDG-PET of the brain shows hypermetabolic foci in basal ganglia (i), while no metabolic alteration on both hippocampi (l) is detectable.

Box 2. Ictal EEG: a theta rhythmic activity starts on the left temporal region, then spreads bilaterally and evolves to a delta activity mixed with sharp waves, persisting predominantly on bi-temporal region for a total length of 63 ​s. Clinically, the patient presents behavioral arrest, right head and eyes deviation, chewing automatisms.