Diagnosis: Epilepsy, unspecified, not intractable, without status epilepticusClinical question: migraines and seizure disorder + auras (oscillopsia) she thinks = "pre-seizure," Semiology most consistent with complex-partial seizures, although give early age of onset cannot ru The CSF spaces are appropriate for the patient's stated age with no midline shift. A small focus of T2 and FLAIR signal hyperintensities present along the left external capsule. In isolation is probably of little clinical significance.The hippocampi are symmetric in size morphology and signal characteristics with no abnormal foci of enhancement and no abnormal signal characteristics.No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified 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.
MRI of the brain is within normal limits. There is no evidence for intracranial mass lesion to explain patient's seizures.