PMC7184158_01
Continuous right posterior quadrant seizures.. This is an A-P longitudinal bipolar montage. The top Fig. 1a shows semi-rhythmic right posterior quadrant slowing depicted by the blue arrow. Fig. 1b shows a buildup of activity with fast spikes having a maximum negativity at O2 depicted by the green arrow. Fig. 1c shows spread to the posterior temporal region and continued evolution depicted by the red arrow.
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Despite treatment with valproic acid and topiramate, an EEG showed nearly continuous partial seizures with a maximum in the right posterior quadrant (Fig. 1).
Right occipital lobe cortical and subcortical T2/FLAIR hyperintensity and gyral swelling.. The top figure (Fig. 2a) is a T2 weighted axial image comparing the initial MRI (left) to subsequent images (right). The blue arrow depicts T2 prolongation in the right posterior temporal and occipital region. The bottom figure (Fig. 2b) is the axial FLAIR image with the red arrow pointing to the same area of abnormality.
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T2 prolongation with gyral swelling in the right temporal, parasagittal, parietal, occipital lobes, and right pulvinar without caudate involvement (Fig. 2). There was also right cerebral and cerebellar volume loss (Fig. 3).
Right occipital lobe gyral swelling and T2 hyperintensity (blue curved arrow) and ipsilateral cerebellar volume loss (red straight arrow).. This is a coronal T2 weighted image comparing the initial MRI (left) to subsequent images (right). The blue curved arrow depicts right occipital lobe gyral swelling and T2 hyperintensity while the red arrow depicts ipsilateral cerebellar volume loss.
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T2 prolongation with gyral swelling in the right temporal, parasagittal, parietal, occipital lobes, and right pulvinar without caudate involvement (Fig. 2). There was also right cerebral and cerebellar volume loss (Fig. 3).