We report a girl with Panayiotopoulos syndrome (PS) associated with sporadic hemiplegic migraine (SHM). A 4-year-and-1month old girl with normal development and lack of any family history of neurologic diseases including epilepsy and migraine experienced severe headache, nausea, vomiting and transient left hemiplegia. Similar attacks recurred three times during the subsequent 8 months. Her second attack shared the same symptoms with the first one, which was compatible with SHM. While headache and vomiting were the only manifestations in the third attack, consciousness disturbance with tonic eyes deviation to the left for 20 minutes, followed by vomiting and headache, were observed in the latest episode, all of which were consistent with PS. The interictal EEGs taken after the 4th attack demonstrated repetitive spikes with the right occipital predominance. The ictal manifestations and the EEG findings confirmed her diagnosis as PS.
Previous studies have shown that HM and some idiopathic epilepsies share the mutations of neuronal ion channel genes, implicating that both are the similar channelopathy. Our case suggests that the same neurofunctional abnormality may be responsible for both SHM and PS.

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A 2-year-old boy with mental retardation and right hemiplegia developed postural seizure 10 months after traumatic brain injury. His seizures were controlled with valproic acid until five years of age when he began to demonstrate daily self-induced postural seizures similar to the previous seizures. These seizures, which appeared to be accompanied by a feeling of pleasure, were triggered by sequence of motor and sensory stimuli, consisting of head banging, rapid limb movement, and sound. The first seizure in the morning sometimes evolved into serial spasms, however, subsequent seizures in the same day did not. After a seizure, the stimulating maneuver was no longer effective in provoking additional seizures for a few hours. During the course of the illness, unprovoked seizures also occurred. Both self-induced and unprovoked seizures were resistant to conventional antiepileptic drugs, but ceased dramatically after he began to masturbate at the age of 8 years old. He has remained seizure-free for more than 4 years to date.

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