Right facial droop, admission for seizure disorder. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size. Mild parenchymal loss is seen, relatively greater involving the cerebellum noted. There is focal outpouching involving the right frontal horn laterally which may be related to remote ischemic injury of the adjacent white matter. Brain parenchyma appears otherwise within normal limits. Bilateral hippocampi appear symmetric without findings to suggest mesial temporal sclerosis.No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved. Sella and orbits are grossly within normal limits. Mild mucosal thickening in the paranasal sinuses and small left maxillary mucus retention cyst. Bone marrow signal and extracranial soft tissues are within normal limits.
1. No evidence of acute infarct, hemorrhage, mass, or mass effect. No findings to suggest seizure focus.2. Disproportional volume loss involving the cerebellum which is nonspecific but can be seen with antiepileptic medications.3. Focal outpouching involving the right frontal horn which may relate to remote ischemic injury involving the adjacent white matter.4. No abnormal enhancement or lesions are seen along the course of the facial nerves. Examination was obtained per seizure protocol limiting evaluation for subtle lesions; if clinically indicated, MRI per dedicated facial nerve protocol/IAC study may be helpful.