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Interpret the report

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Reading File
Searching the Web

NHS sinusitis emergency symptoms severe headache swelling confusion when seek urgent medical care

Finding Sources
Searching PubMed

sinusitis AND treatment

Summary of the MRI brain (epilepsy protocol)

The brain MRI is essentially normal. It does not show a structural brain cause for seizures.
Specifically, the report says there is:
  • No brain mass, focal lesion, stroke-like restricted diffusion, or intracranial bleed.
  • No swelling, fluid-pressure problem, or midline shift.
  • Normal ventricles, major brain structures, brainstem, cerebellum, and visible blood-vessel flow.
  • No hippocampal atrophy or abnormal signal. This means no MRI evidence of hippocampal sclerosis, a common structural association with temporal-lobe epilepsy.
  • No cortical dysplasia, a developmental brain abnormality that can cause seizures.

Other findings: sinus and mastoid inflammation

The MRI does show changes in the air sinuses:
  • Right maxillary sinus mucosal thickening: mild inflammation of the lining of the right cheek sinus.
  • Left frontal sinus polyp: a likely benign inflammatory polyp in the left forehead sinus.
  • Fluid level/collection in the sphenoid sinus: compatible with sinus inflammation or sinusitis, especially if there is facial pain, headache, blocked nose, nasal discharge, or fever.
  • Mild inflammation in left mastoid air cells: mild inflammation in the air spaces behind the left ear. This does not by itself mean serious mastoid infection.
  • A nasogastric tube is seen in place, presumably because the patient was hospitalized or receiving tube feeding.

What this means

For epilepsy, this is reassuring: there is no visible structural lesion in the brain on this scan. A normal MRI does not exclude epilepsy, because seizures can occur without an abnormality visible on MRI. The treating neurologist will interpret it along with the seizure description, EEG, medications, and clinical examination.
The sinus changes should be discussed with the treating clinician or an ENT doctor if there are sinus symptoms. Sinusitis commonly causes nasal blockage/discharge, facial pressure, headache, and reduced smell, and often resolves without antibiotics, depending on severity and duration, as described by the NHS sinusitis guidance.
Seek urgent care if sinus symptoms occur with swelling/redness around an eye, vision changes, severe worsening frontal headache, stiff neck, confusion, weakness, or persistent high fever.
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