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Temporal lobe epilepsy

Case contributed by Mostafa Elfeky
Diagnosis probable

Presentation

Seizures for 10 years.

Patient Data

Age: 25 years
Gender: Female
mri

Bilateral widening of the pre-temporal CSF space at the middle cranial fossae suggestive of bilateral anterior temporal lobes hypogenesis associated with bilateral arachnoid cysts.

The right mesial temporal lobe is of much decreased size compared to the left one, with high signal intensity on T2 and FLAIR, loss of cortical foldings and mild dilatation of temporal horn of right lateral ventricle suggestive of mesial temporal sclerosis. The right fornix is thinner.

Diffuse symmetrical ectasia of the supratentorial ventricular system.

Case Discussion

This is a case of a young female patient with a long history of epilepsy on treatment, showing some imaging findings that support temporal lobe epilepsy; unilateral decreased size of mesial temporal lobe reflecting mesial temporal sclerosis and bilateral temporal arachnoid cysts that may reflect temporal lobe hypogenesis. Of the secondary signs, thin fornix is also noted.

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