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Dr. Andrew Rynne

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Taking treatment for epilepsy. MRI showed mild atrophy with loss of normal digitations. Any advice?

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Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 5684 Questions

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Posted on Thu, 20 Dec 2012 in Epilepsy
Question: My daughter 20, is under treatment of some type of epilepsy for the last 4 years. Torvate 200+300mg. MRI says:Mild atrophy of the head of right hippocampus with loss of normal digitations. However no evidence of altered signal seen in FSE T2WI and FLAIR.
Mild prominence of the right choroid fissure and uncal recess of temporal horn.
MR imaging reveals no significant structural abnormality in the hippocampus or temporal lobe on left side. No abnormal signal.
Rest of the brain parenchyma and other observed structures appear normal. Yesterday she happened to awake in mid-sleep. She had one hand jerk. This is the symptom in first. Before start treatment she fainted two times after hand jerks.
She is doing her MCom in college. Is this any severe, or uncuable, any problem if married. Please advise. Thank you.
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Answered by Dr. Sudhir Kumar 12 minutes later
Hi,

Thank you for posting your query.

Epilepsy is a common problem, and it has no adverse effects on normal routine life.

MRI findings represent a cause for her epilepsy, and this minor abnormality would not affect her brain functions, which means she can do normal studies and job.

She can get married, and have normal married life (including pregnancy). However, she needs to continue anti-epileptic medications, as per the doctor's advice.

Torvate (sodium valproate) is alright now, however, it should be replaced with another drug, when someone is planning pregnancy (which will be done after she gets married).

I hope it clarifies. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad
YYYY@YYYY
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sudhir Kumar 2 days later
Thanks. Problem in right brain and right hand jerks. is this possible
doctor
Answered by Dr. Sudhir Kumar 2 hours later
Hi,

Thank you for getting back.

MRI XXXXXXX does not show all the abnormalities of the brain in epilepsy. EEG and PET scan are other methods.

Right hand jerks are related to abnormal discharges from the left brain (this may get picked up on EEG or PET scan), however, it is not required to do, as clinical picture is enough to initiate the treatment in epilepsy. However, in research studies, one would have to prove the origin of jerks.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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