Diagnosis: Generalized nonconvulsive epilepsy without mention of intractable epilepsyClinical question: Evaluate for epileptic focusSigns and Symptoms: Staring spells; EEG demonstrates generalized and focal dischargesComments: Patient will try without sedation first. Seizure II protocol to be performed. | 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. There is no evidence for diffusion restriction 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 are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.The visualized nasopharyngeal tissues are thick. This is not unusual at this age.
MRI of the brain is within normal limits. There is no evidence for intracranial mass, congenital brain abnormality or mesial temporal sclerosis on the basis of this exam