Teaching NeuroImages: New-onset focal epilepsy

A 54-year-old right-handed woman was referred for evaluation of drug-resistant epilepsy. At age 16, while riding in a park in Perth, Western Australia, she had been thrown from her horse, which had been startled by a rogue camel. There was no significant head injury but the patient subsequently noted a “clicky” jaw. At age 37, she developed recurrent episodes involving a sense of disconnection followed by dysphasia.