A 33-year-old woman had two episodes of right arm and forearm jerking movements lasting 2 to 5 minutes about 3 years prior to this evaluation. Three months later, she had an 18-hour episode of continuous jerking involving her lower abdomen and right arm. Two years later, she had a 10-minute episode of jerking movements involving her right foot followed by loss of consciousness and postictal confusion. A month later, she had another 10-minute episode characterized by right foot jerking movements. Since the last event, she had noted impaired dexterity of her right foot and tripping episodes while walking upstairs. She had no history of perinatal problems, meningitis, or encephalitis.

Our patient had simple partial seizures manifested by elementary motor (clonic) symptomatology. Initially, only her right arm was affected, but with her second spell, both her right arm and lower abdomen were involved. She discontinued antiepileptic drug (AEDs) use for an attempted pregnancy. Her next spell consisted of a partial seizure (right foot) followed by secondary generalization. AEDs were restarted. After her last spell, she reported residual decreased dexterity of right foot movements.