Diagnosis: Epilepsy, unspecified, not intractable, without status epilepticusClinical question: seizure; evaluate for structural abnormalitySigns and Symptoms: seizure The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.A couple punctate periventricular white matter lesions present which are high signal on T2 and FLAIR MRI and not changed since the prior exam.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 some scattered opacities which are unchanged since prior exam. The visualized portions of the mastoid air cells are partially opacified The visualized portions of the orbits are intact. There is somewhat more opacification of the mastoid air cells on the current exam when compared to the previous exam.Incidental note is made of partial empty sella finding which was previously present as well.
1.No abnormal mass lesions or other lesions are identified intracranially to explain the patient's seizures. MRI of the brain is age-appropriate.2.Opacification of mastoid air cells is nonspecific but could be related to retained secretions. It is somewhat more evident on the current exam when compared to the prior