Diagnosis: Unspecified convulsionsClinical question: Evaluate for seizure like activity, patient is admitted to LTMSigns and Symptoms: Episode of GTC like activity in her sleep witnessed by husband. No known gaze deviation or focality noted. The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate opacification of a right sphenoid sinus air cell. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. There is a 3mm submucosal cystic nodule present in the nasopharyngeal mucosal space which is probably benign
MRI of the brain is within normal limits. There is no evidence for intracranial mass lesion and no evidence for cerebral infarction to explain the patient's tonic-clonic seizures.