Female, 56 years old, with moderate intellectual disability and seizures since childhood with generalized tonic-clonic's and drop attacks and with generalized slow spike-and-wave on EEG. Scattered small foci of white matter T2 hyperintensity are seen without significant mass effect or edema. No restricted diffusion is evident. No pathologic parenchymal or extra-axial enhancement is detected.The mesial temporal lobes demonstrate symmetric morphology and signal characteristics. No structural abnormalities are detected here or elsewhere in the brain.There are no findings to suggest acute intracranial hemorrhage or any abnormal extra-axial fluid collection. The ventricles are normal in size and morphology. The cerebellum is small relative to the posterior fossa suggesting cerebellar volume loss.
1.Scattered nonspecific foci of white matter signal abnormality.2.Volume loss of the cerebellum which may be secondary to long-term anticonvulsant therapy or other medications or toxic exposures.3.No additional structural abnormalities are seen to account for the patient's seizures.