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Patient 8, hyperintense signal intensities that preceded focal atrophy. Coronal FLAIR images at (a) 3 years, (b) 4 years, (c) 8 years and (d) 18 years from clinical onset. Focal atrophy limited to right perisylvian and insular region at the first MRI scan was followed by hyperintense alteration both of GM and WM in insula and frontal lobe (b,c, arrowhead). These alterations preceded worsening of the atrophic changes in the same areas.
