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The finding of unusual facial features or hepatosplenomegaly points to an underlying metabolic or storage disease. Examination for café-au- lait spots and the presence of retinal phakoma indicates a neurocutaneous disorder . Localizing neurologic signs such as subtle hemiparesis with hyperreflexia , an equivocal Babinski , and a downward -drifting extended arm with eyes closed might suggest a contralateral hemispheric structural lesion , such as a slow - growing temporal lobe glioma, as the cause of the seizure disorder .