PMC8813978_01
Brain MRI of case 1. After the first attack of an epileptic seizure, the hyperintense lesions with a hazy border in the bilateral cortex on fluid-attenuated inversion recovery (FLAIR) (A) and T2-weighted (C) images (arrowheads), which were less evident on T1-weighted (B) and diffusion-weighted (D) images. FLAIR hyperintensities in the cortical regions became shallow and fewer after 3 months (E) (arrowheads). After the second attack that presented with dizziness and left-sided ataxia, the hyperintensities in the pons and left brachium pontis on FLAIR (F), T1-weighted (G), T2-weighted (H), and diffusion-weighted (I) images (arrowheads). The FLAIR hyperintensities in the brainstem became shallow and smaller after 1 month (J).
fneur-12-775181-g0001.jpg
PMC8813978_01_fneur-12-775181-g0001.jpg
F1
Poorly marginated, hyperintense lesions in the left frontotemporal parietal lobe and the right frontal lobe were displayed on both FLAIR (Figures 1A, 2A-E) and T2-weighted images of cranial MRI (Figure 1C), which were less evident on T1-weighted (Figure 1B) and diffusion-weighted images (Figure 1D). A follow-up brain MRI after 3 months suggested that FLAIR hyperintensities in the bilateral cortical regions were shallow and fewer (Figures 1E, 2F). Cranial MRI revealed FLAIR-hyperintense (Figure 1F), T1-hyperintense (Figure 1G), T2-hyperintense (Figure 1H), and diffusion-hyperintense (Figure 1I) lesions in the pons and left brachium pontis. The FLAIR hyperintensities in the brainstem were shallow and smaller after 1 month (Figure 1J).
Brain MRI of cortical lesions in cases 1 and 2. FLAIR hyperintensity was seen in the bilateral cerebral cortex in case 1 (A-E) and in the left hemispheric cortical region in case 2 (G-K) (arrowheads). However, the FLAIR hyperintensities in the cortical regions became shallow and fewer after 3 months in case 1 (F) and disappeared after 1 month in case 2 (L).
fneur-12-775181-g0002.jpg
PMC8813978_02_fneur-12-775181-g0002.jpg
F2
The brain MRI showed FLAIR-hyperintense lesions in the left frontal lobe (Figures 2G-K). The FLAIR hyperintensities in the unilateral cortical regions disappeared after 1 month (Figure 2L).
PMC8813978_02
Brain MRI of cortical lesions in cases 1 and 2. FLAIR hyperintensity was seen in the bilateral cerebral cortex in case 1 (A-E) and in the left hemispheric cortical region in case 2 (G-K) (arrowheads). However, the FLAIR hyperintensities in the cortical regions became shallow and fewer after 3 months in case 1 (F) and disappeared after 1 month in case 2 (L).
fneur-12-775181-g0002.jpg
PMC8813978_02_fneur-12-775181-g0002.jpg
F2
The brain MRI showed FLAIR-hyperintense lesions in the left frontal lobe (Figures 2G-K). The FLAIR hyperintensities in the unilateral cortical regions disappeared after 1 month (Figure 2L).
PMC8813978_03
Brain MRI of brainstem lesions in cases 3 and 4. A nodular hyperintense lesion in the left brachium pontis on FLAIR (A), T2-weighted (C), and diffusion-weighted (D) images (arrowheads). However, it was hypointense on the T1-weighted image (B), and with a gadolinium-enhanced edge on the T1-weighted image (E) (arrowheads). Hyperintense lesions in the left brachium pontis, left cerebellar hemisphere, and cerebellar vermis on FLAIR (F), T2-weighted (H), and diffusion-weighted (I) images (arrowheads). However, it was hypointense on the T1-weighted image (G), and with curvilinear post-gadolinium contrast enhancement on the T1-weighted image: axial (J), sagittal (K), and coronal (L-N) (arrowheads).
fneur-12-775181-g0003.jpg
PMC8813978_04_fneur-12-775181-g0003.jpg
F3
T1-hypointense (Figure 3G), T2-hyperintense (Figure 3H), FLAIR-hyperintense (Figure 3F), and diffusion-hyperintense (Figure 3I) lesions with curvilinear post-gadolinium contrast enhancement (Figures 3J-N) in the left brachium pontis, left cerebellar hemisphere, and cerebellar vermis. The CSF analysis showed a mild increase in leukocytes (55/mul) and normal protein levels.
PMC8813978_04
Brain MRI of brainstem lesions in cases 3 and 4. A nodular hyperintense lesion in the left brachium pontis on FLAIR (A), T2-weighted (C), and diffusion-weighted (D) images (arrowheads). However, it was hypointense on the T1-weighted image (B), and with a gadolinium-enhanced edge on the T1-weighted image (E) (arrowheads). Hyperintense lesions in the left brachium pontis, left cerebellar hemisphere, and cerebellar vermis on FLAIR (F), T2-weighted (H), and diffusion-weighted (I) images (arrowheads). However, it was hypointense on the T1-weighted image (G), and with curvilinear post-gadolinium contrast enhancement on the T1-weighted image: axial (J), sagittal (K), and coronal (L-N) (arrowheads).
fneur-12-775181-g0003.jpg
PMC8813978_04_fneur-12-775181-g0003.jpg
F3
T1-hypointense (Figure 3G), T2-hyperintense (Figure 3H), FLAIR-hyperintense (Figure 3F), and diffusion-hyperintense (Figure 3I) lesions with curvilinear post-gadolinium contrast enhancement (Figures 3J-N) in the left brachium pontis, left cerebellar hemisphere, and cerebellar vermis. The CSF analysis showed a mild increase in leukocytes (55/mul) and normal protein levels.