Long standing epilepsy.
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Abnormal thickening of the posterior portions of the left superior and middle frontal gyri are identified. The greater resolution of today's scan allows delineation of separate small foci of grey matter intensity areas deep to the thickened cortex, consistent with additional nodular heterotopia. The T2 weighted scans shows abnormal signal extending from the thickened and nodular areas through the optic radiation to the ependyma of the left occipital horn.
A probable small arachnoid cyst within the quadrigeminal system mildly deforms the quadrigeminal plate and the central lobule of the vermis. No other abnormality seen. In particular, the medial temporal structures appear normal.
Confirmation of pachygyria/polymicrogyria in posterior portion of left temporal lobe, adjacent nodule heterotopia and probable dysmyelination within the adjacent white matter. Incidental small quadrigeminal system arachnoid cyst.