Mesial temporal sclerosis
Long-standing history of seizures.
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Selected images demonstrate a small right hippocampus with increased T2 signal consistent with right-sided mesial temporal sclerosis.
The patient went on to have a hippocampectomy.
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