Presentation
Temporal epilepsy.
Patient Data
Focal cortical thickening centered on the right middle temporal gyrus with a blurring of white matter-grey matter junction and high T2/FLAIR subcortical white matter with no transmantle sign. No diffusion restriction or enhancement on the postcontrast sequence.
Reduced volume of the right hippocampus compared to the left with increased signal on T2/FLAIR most consistent with hippocampal sclerosis.
Case Discussion
MRI features highly suggestive of a focal cortical dysplasia with associated ipsilateral hippocampal sclerosis, type IIIa according to Blumcke classification of focal cortical dysplasia.
Focal cortical dysplasias (FCD) represent a heterogeneous group of disorders of cortical formation, which may demonstrate both architectural and proliferative features. They are one of the most common causes of epilepsy and can be associated with hippocampal sclerosis (as in this case) and cortical glioneuronal neoplasms.
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