Mesial temporal sclerosis

Case contributed by Dr Nikola Todorovic


Follow-up examination for a patient on antiepileptic therapy.

Patient Data

Age: 20
Gender: Male

There is a mild atrophy of hippocampus on the right, with a dilatation of the temporal horn of the lateral ventricle and no evident changes of the signal intensity.

There are also cortical and subcortical atrophic cerebral and cerebellar changes with the consecutive widening of subarachnoidal space, and a few retrocerebellar subarachnoidal cysts (differential diagnosis) up to 40 mm.

Two retentional cysts are present in the left maxillary sinus.

Case Discussion

The patient had the first seizure during the sleep when he was 7. MRI brain performed at that time was reported as normal.

Another seizure occurred 8 years later with the head deviation to the left, upward eyes deviation and clonic extremities movements for about 2 minutes. He then had another MRI brain and was diagnosed with mesial temporal sclerosis.

Since then, he is on the antiepileptic therapy and had no more attacks. EEG is normal. He is physically and mentally adequately developed.

Case courtesy of Dr Ana Brankovic.

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