ABSTRACT
Dimitri's presenting problem was first noted three months ago by his teacher, at the beginning of first grade. Known to family members as Didi, Dimitri had performed well during his senior kindergarten year, being above the class average. Having finally returned from basic consideration of neuronal membrane function and mechanisms of epileptogenesis to intermittent behavioural abnormalities in Didi ascribed as epileptic seizures, it is now necessary to briefly look at the sundry patterns of clinical epileptic seizures that few fundamental epileptogenic mechanisms may evoke. If the initial symptom of the seizure consists of rhythmic twitching of the thumb, sequential localized spread will lead to twitching of the hand, arm, shoulder and ipsilateral face, a phenomenon called a Jacksonian march, named after Hughlings Jackson, who originally described it. Didi's neurological disorder is clearly quite different from those you have encountered previously. His symptoms are intermittent rather than relentlessly progressive; he appears to be completely normal when his symptoms are not present.
