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At age 15 months, this previously healthy girl presented with an unprovoked seizure with right-sided clonic movements and facial twitching for 8 minutes. Serial MRIs revealed evolution from diffusion-weighted changes suggestive of edema to left hippocampal hyperintensity on T2 images and subsequently atrophy suggestive of mesial temporal sclerosis (MTS)1 (figures 1 and 2). After seizure freedom for 6 months, she presented with seizures characterized by staring, lip smacking, swallow automatisms, and gagging. Left temporal lobectomy for pharmacologically intractable epilepsy confirmed MTS on pathologic examination with seizure freedom since then. This case …

Teaching Neuro Images : Mesial temporal sclerosis after a prolonged unprovoked seizure in an infant