Hi all! I had a seizure for the first time on 3/1 and I lost consciousness for 2 minutes. Everything like labs checked out but I have sjogrens and have been diagnosed within the last 6 months so my neurologist thinks that my sjogrens could now be affecting the central nervous system. He ordered a brain mri that I have attached here as well as a lumbar puncture that came out totally normal. I had no warning signs with the seizure so he has ordered a 72 hour VEEG which was complete torture, I’m still waiting on results almost 3 weeks later. I am told that he has to transcribe the results and hopefully by follow up on may 20th he’ll be able to clear me to drive again. Is this normal to take over a month to transcribe the VEEG results?
Brain MRI results are:
INDICATION: New onset seizure and progressive cognitive dysfunction in the setting of new diagnosis of Sjogren's syndrome concerning for autoimmune/inflammatory encephalitis.
TECHNIQUE: MR imaging of the brain was performed in multiple planes with multiple sequences prior to and following intravenous administration of gadolinium contrast. 14 mL of Dotarem was injected via the right antecubital vein.
COMPARISON: Brain MRI without and with contrast performed at another institution on 4/3/2024. Noncontrast brain
MRI performed at another institution on 10/4/2022.
FINDINGS:
Brain parenchyma: No mass, mass effect, or midline shift. No restricted diffusion, infarct, or parenchymal hemorrhage.
There is equivocal increased signal at the mesial temporal lobes/limbic system bilaterally on T2 FLAIR, similar to the prior examinations. No definite white matter change. No pathologic parenchymal enhancement. Potential small developmental venous anomaly at the right frontal lobe laterally is redemonstrated (axial T1 postcontrast image #22; coronal T1 postcontrast image #14).
Ventricles, sulci, and cisterns: Normal.
Extra-axial space: No pathologic collection.
Meninges: No pathologic thickening or abnormal enhancement.
Flow voids: Intact major vascular flow voids.
Paranasal sinuses and mastoid air cells: Clear paranasal sinuses. Trace nonspecific fluid involving mastoid air cells bilaterally, left side more than right, is new.
Globes and orbits: Unremarkable.
Calvarium and extracranial structures: Unremarkable.
IMPRESSION:
No infarct. No intracranial hemorrhage or mass. Equivocally increased signal at the mesial temporal lobes/limbic system bilaterally on T2 FLAIR is similar to the prior examinations. Please correlate clinically. No pathologic parenchymal enhancement. No pathologic thickening or abnormal enhancement of the meninges.
Potential small developmental venous anomaly at the right frontal lobe, usually an incidental finding.
Trace nonspecific mastoid air cell fluid bilaterally is new.