Temporal lobe seizures. Recent video-EEG study showed right temporal lobe interictal spikes and he had five seizures originated from right temporal lobe. There is suggestion of mild gyriform T2 hyperintensity in the inferior right temporal lobe. The hippocampi are unremarkable. There is no evidence of intracranial hemorrhage, discrete mass, or acute infarct. There are a few scattered punctate foci of nonspecific T2 hyperintensity in the white matter. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
Suggestion of mild gyriform T2 hyperintensity in the inferior right temporal lobe, which may represent an underlying cortical dysplasia, perhaps with superimposed edema related to seizure activity. A neoplastic process is less likely. Nevertheless, further evaluation via an MRI with contrast may be useful.