Clinical question: Seizure protocol. Signs and symptoms: 21 year old male with epilepsy since age 13. EEG left frontal temporal spikes in the past. Nonenhanced brain MRI:Unremarkable diffusion weighted series.Examination demonstrates normal anatomical development of brain parenchyma.There are few tiny foci of FLAIR hyperintensity in the subcortical white matter of the bilateral cerebral hemispheres which are nonspecific.The anatomical morphology as well as the signal intensity of brain parenchyma is otherwise within normal on all MRI sequences. In particular there is no detectable abnormal anatomical morphology or signal intensity of the left frontotemporal region.Unremarkable CT pole cortex, cortical sulci, ventricular system and CSF spaces.Signal void of major intracranial arterial branches are identified.Unremarkable calvarium, soft tissues of the scalp, orbits, mastoid air cells, middle ear cavities and all visualized paranasal sinuses.
1.Negative diffusion-weighted images.2.Few punctate-sized subcortical foci of nonspecific FLAIR hyperintensity.3.Unremarkable nonenhanced brain MRI otherwise and in particular no detectable signal abnormality of the left frontal temporal region.