Fig. 2
A 11-year-old male patient presented with focal seizures. The structural MR images, including axial T2WI (a), axial FLAIR image (b), axial 3D T1WI (c), axial DWI (d), all are unremarkable and negative. The MV 1H-MRS picture maps are demonstrated in e and f. The MRS spectra of the right and left temporal lobes reflect the decrease in NAA/(Cho + Cr) and (NAA/Cr) ratios in the zone of epileptogenic activity in both temporal lobes, on the right temporal lobe (e) measuring about 0.56 and 1, respectively, and on the left temporal lobe (f) measuring about 0.57 and 1.5, respectively. The FA map (g) revealed focal decrease in the FA value in both temporal lobes measuring 0.15 on the right side and 0.14 on the left side, respectively (white arrows), while MD map (h) revealed focal increase in the MD value in both temporal lobes measuring 8.6 × 10–3 m2/sec on the right side and 8.8 × 10–3 m.2/sec on the left side (white arrows). The ASL-MRI color-coded cerebral perfusion map (i) reveals scattered foci of hypoperfusion of both temporal lobes with rCBF measuring about 62 ml/100 g/min on the right side, while measuring 65 ml/100 g/min on the left side (white arrows)