Facial asymmetry since childhood and hyperreflexia here for evaluation of possible multiple sclerosis. There are a few scattered punctate foci of T2 hyperintensity in the cerebral white matter, particularly the frontal lobes. There is no evidence of intracranial hemorrhage, mass, or acute infarct. There is no abnormal intracranial enhancement. 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. There is minimal fluid signal in the left mastoid air cells. There is anterior nasal deviation to the left.
1. A few scattered punctate foci of T2 hyperintensity in the cerebral white matter, particularly the frontal lobes, are nonspecific, but perhaps related to chronic small vessel ischemic disease, but no compelling findings for intracranial demyelinating lesions otherwise.2. Anterior nasal deviation to the left.