Presentation
New onset seizures. Normal neurological examination.
Patient Data
Hyperintensity in the left hippocampus which corresponds with an area of atrophy on the T2W coronal study.
No other abnormalities in the study.
Asymmetry between the mesial temporal lobes with the left atrophic side highlighted in red.
This area corresponds to the hippocampus.
Case Discussion
This asymmetry between the mesial temporal lobes is recognized as mesial temporal sclerosis.
This is a finding in temporal lobe epilepsy.
If dedicated "epilepsy protocol" scans are performed, this abnormality can be identified and allows better discussion with the patient about prognosis. These epilepsies can be hard to control with medication but have good results from surgery with resection of the abnormal lobe.
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Thanks to Dr Arthur Daire for contributing the case to Radiopaedia.org. The original case can be found here.
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