PMC6064196_01
Axial T2 MRI of MTS progression and post-operative outcome. A) Axial FLAIR MRI following cyclosporine-induced seizure showing diffuse occipital and parietal signal intensity increase consistent with posterior reversible encephalopathy syndrome (PRES). No preexisting mesial temporal sclerosis present. B) Axial FLAIR MRI after first seizure recurrence showing subtle signal intensity increase in right insular cortex and hippocampus with volume loss. C) Axial FLAIR MRI 10 months post-seizure recurrence showing slight right hippocampal signal intensity and volume loss indicative of right mesial temporal sclerosis (MTS). D) Coronal FLAIR MRI 2 years post-seizure recurrence showing marked right hippocampal signal intensity and volume loss. E) Axial FLAIR MRI showing post-operative resection of hippocampus and amygdala.
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MRI at the time of seizure recurrence (Fig. 1) showed a subtle signal intensity increase in the right insular cortex and hippocampus and atrophy in the right parietal lobe. MRI (Fig. 1) and PET imaging at 2 years' post-seizure recurrence revealed right mesial temporal sclerosis (MTS) and right temporal hypometabolism, respectively.