Deviation of the head or eyes at the onset of a seizure usually sugges
ts that the seizure focus is located in the contralateral hemisphere.
We describe an infant with extensive cerebral dysgenesis in whom left
frontal ictal discharges on EEG were consistently correlated with left
ward deviation of the head and eyes. Resection of the left frontal lob
e eliminated the focal ictal discharges and versive head and eye movem
ents. Thus, in an abnormally formed immature brain, ictal head and eye
movements are not necessarily associated with contralateral ictal dis
charges, and such ictal discharges can be falsely localizing.