The hippocampal head, hippocampal body and amygdala on the right demonstrate increased T2 signal and appear bulkier than the counterpart on the left. There is increased DWI signal, with only slightly facilitated diffusion on ADC. There is apparent faint enhancement within the amygdala only seen on coronal images which is not definitely a real finding.
MR perfusion appears symmetric. MR spectroscopy is non-contributory.
Conclusion
Swelling increased T2 signal of the right hippocampus and amygdala has a differential of infiltrating tumour and limbic encephalitis (e.g. paraneoplastic). Limited, if any, change over the previous two weeks both on imaging and clinical status, makes herpes encephalitis very unlikely. The changes are too pronounced and persistent to represent post-seizure effects.