Other epilepsy, not intractable, without status epilepticus [G40.802], Reason for Study: ^Reason: please re-evaluate s/p lupus cerebritis with seizures History: Lupus cerebritis, temporal lobe epileptiform discharges Previously seen mass like lesions with peripheral enhancement and susceptibility artifacts at the right frontal lobe and left basal ganglia have been significantly reduced in size and changed MR characteristics. Specifically, the right frontal lobe lesion shows gyriform cortical encephalomalacia with enhancement and the left basal ganglia lesion only shows focal enhancement. Both lesions do not show surrounding edema. And both lesions show susceptibility artifacts indicating prior intralesional hemorrhages. There are remained FLAIR/T2 high signal intensity lesions on bilateral periventricular white matter which again have been significantly decreased in their extent.There is no evidence of acute ischemic or hemorrhagic lesion on this scan.There is no other abnormal enhancing lesion.Constellation of above findings indicate interval improvement of multifocal brain lesions likely related to patient's SLE. Continuous enhancement of both right frontal and left basal ganglia lesions may indicate sustained inflammatory reactions. The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The paranasal sinuses and mastoid air cells are clear.Multiple enhancing nodules within the right parotid gland indicating benign lesions such as pleomorphic adenoma, unchanged.
1. Significant interval reduction of peripheral enhancement, surrounding edema and mass effects of both right frontal lobe and left basal ganglia lesions since prior scan since prior scan.2. Remained enhancement of above lesions may indicate sustained inflammatory reactions.3. No evidence of acute ischemic or hemorrhagic lesion on this scan. 