Snapshot A 39-year-old man presents to the emergency department due to abnormal movement of his left arm. These involuntary abnormal movements last a few minutes and he is aware during these episodes. He also endorses right-sided headaches that are worse in the morning. Medical history is unremarkable. Physical examination is normal. An MRI brain with and without gadolinium demonstrates a right-sided ring-enhancing lesion in the primary motor cortex. Neurosurgery is consulted for removal and histopathological assessment of the mass. (Brain neoplasm) Introduction Definition login to view 1 more bullet Etiology Structural brain abnormality login to view 7 more bullets Pathogenesis The structural brain lesion results in electrogenic variation, creating a focus for epileptogenesis Presentation Symptoms/physical exam login to view 3 more bullets Imaging MRI brain with and without contrast login to view 3 more bullets Studies Electroencephalogram (EEG) login to view 2 more bullets Differential Psychogenic nonepileptic seizures (PNES) login to view 4 more bullets Migraine with aura login to view 2 more bullets Treatment Medical login to view 5 more bullets Complications Behavioral and cognitive alterations Aspiration Prognosis Partial seizures are at higher risk of seizure recurrence than generalized seizures