Mesial temporal sclerosis (unilateral)
H/o complex partial seizures
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There is volume loss and hyperintensity in the right hippocampus with a prominent temporal horn
note also the secondary signs in form of atrophy of the ipsilateral mamillary body and ipsilateral fornix.
Presence of primary signs means that the patient has a 70 - 90% chance of being seizure free after surgery as opposed to 50% if these signs are absent
The identification of secondary signs can increase the specificity of these findings.