Presentation
History of seizures from the age of 2, with alterations of consciousness and memory.
Patient Data
A smaller volume of the left hippocampus is observed with respect to its contralateral side, associated with increased signal in FLAIR sequence, which could be related to mesial temporal sclerosis.
Case Discussion
This is a case of mesial temporal sclerosis (TMS), which causes temporal lobe epilepsy refractory to treatment in this patient. This case reflects the typical appearances of neuronal loss and gliosis in the hippocampus, with reorganization of neuronal pathways and formation of an epileptogenic focus.
His main findings are:
the decrease in hippocampal volume was identifiable on 3D SPGR (three-dimensional disrupted gradient echo) T1 or T2 sequences in the oblique coronal plane, with visually or volumetrically determined asymmetry
hyperintensity and loss of hippocampal fingering, especially in FLAIR (Fluid Attenuated Inversion Recovery) sequence in coronal slices
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