Mesial temporal sclerosis

Case contributed by Royal Melbourne Hospital
MRI

MRI brain

On T2, the left hippocampus (head and body) is smaller compared with right (see the apparent larger temporal horn). It has also lost the trilaminar appearance and undulating contour -- still preserved on the right. On FLAIR, there is subtle but definite increase in intensity within the left hippocampus.

Nuclear medicine

SPECT

Ictal: No hyperperfusion seen. Hypoperfusion seen in left temporal and parietal lobes.

Interictal: Focal hypoperfusion of left temporal lobe.

Conclusion: Although there is no active focus of epilepsy, hypoperfusion of left temporal lobes in both studies is consistent with left MTS.

Pathology

Histology

1. Temporal lobe lateral: Mild Chaslin's sclerosis only.
2. Hippocampus: Hippocampal sclerosis - Blumcke Type Ia.
3. Maxilla, uncus; Focal cortical dysplasia - Taylor Type IIa.

Case Discussion

This case is in progress.

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Case information

rID: 15184
Published: 30th Sep 2011
Last edited: 13th Dec 2019
Inclusion in quiz mode: Included

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