The patient’s magnetic resonance imaging (MRI) at 10 months after the seizure onset. He had intermittent paresthesia in the left leg, and his reflexes were increased in his right arm and leg. A, Axial fluid-attenuated inversion recovery (FLAIR) imaging of the brain shows ill-defined hyperintense lesions in the periventricular regions. B, Sagittal T1-weighted image of the spinal cord shows new short hyperintense lesions affecting the brainstem, the cervical spinal cord, and upper thoracic spinal cord (arrows).