Fig. 11

Bilateral hippocampal sclerosis and dual pathology. 3-T coronal T2-weighted image in a 35-year-old patient with medically refractory epilepsy shows volume loss and increased signal intensity of the right hippocampus, compatible with mesial temporal sclerosis (a). The left side the hippocampal volume looks normal, but T2 signal intensity is slightly increased in the CA1 and CA2 sectors and there is blurring of the internal structure (a). On follow-up MRI performed 3 years later, there is clear bilateral hippocampal sclerosis with atrophy and increased T2 signal intensity of both hippocampi (b). Axially reconstructed 3D MPRAGE images (c) show multiple periventricular heterotopias (white arrows) along the lateral wall of the left lateral ventricle