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Most frontal-lobe seizures present as contralateral clonic movements, unilateral or bilateral tonic motor activity, bizarre movements, complex automatism, and inconsistent patterns of cognitive impairment [1]. These diverse presentations make them a diagnostic challenge. Dyscalculia is an impairment in which patients have difficulty doing simple mathematical tasks; it is usually acquired late in life because of a neurological injury. This is seen primarily in patients with dominant-hemisphere lesions. We report a 67-year-old man with late-onset nondominant frontal-lobe seizures and ictal dyscalculia as the main manifestation.

A 67-year-old retired high school teacher, right-handed and a regular mahjong player, presented in our emergency room with bouts of dull response when playing mahjong. He had been playing mahjong for 3 hours that day. He was transfixed and poorly responsive for about 5 minutes in the …