Presentation
Known case of epilepsy on treatment for 20 years, now with increased frequency. Also, sudden onset of swelling on the right cheek.
Patient Data
Left hippocampus appears rounded with loss of the normal architecture and vertical orientation of the collateral sulcus, likely suggesting incomplete hippocampal inversion. Adjacent ventricle appears normal.
Prominence of the temporal horn of the right lateral ventricle, without significant atrophy of the adjacent hippocampus or abnormal FLAIR signal within.
A well-defined soft tissue lesion in the right nasolabial region in the subcutaneous plane with heterogeneous T1/T2 signal, no restriction of diffusion, likely suggestive of benign etiology - possible differential diagnoses:
nasolabial cyst with secondary infection
dermoid cyst
Case Discussion
The coronal T1 IR and T2W sequence reveal abnormal internal architecture in the left hippocampus, without atrophy or abnormal signal. This 'incomplete inversion' of the hippocampus could be the potential epileptogenic focus in this patient.
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