Mesial temporal sclerosis

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Long-standing history of seizures.

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

mri
Coronal
FLAIR
Coronal
T1
Coronal
T2
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Info

Selected images demonstrate a small right hippocampus with increased T2 signal consistent with right-sided mesial temporal sclerosis.

Case Discussion

The patient went on to have a hippocampectomy. 

Histology

Sections of the mesial structures confirm mesial temporal sclerosis, which is represented by a profound depletion of neurons within CA1. A localized aggregate of neurocytic cells is observed, equivalent to focal microdysgenesis. No other diagnostic neuropathologic findings are seen. Subpial gliosis is evident.

Final diagnosis:  mesial temporal sclerosis

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