I answered this via process of elimination.

A) Gliobastoma multiforme - no b/c that would need to show a tumor B) HSV encephalitis - would need to be in the temporal region and also doesn’t quite fit with the 25 year seizure disorder history C) Mesial temporal sclerosis - i have no idea what this is really, but judging from “sclerosis” i assume there needs to be some signs of sclerosis which is not present in the photo D) Neonatal ischemic stroke - no she old E) Vascular malformation - could not think of a vascular disorder that was associated with seizures, but it makes sense b/c the picture shows a bunch of dilated spaces which I assumed are the vessels being malformed

Symptoms of brain AVMS (arteriovascular malformations) include seizures. Brain avms can be found in HHT (hereditary hemorrhagic telangiectasia / Osler Weber Rendu syndrome). More info here: https://www.mayoclinic.org/diseases-conditions/brain-avm/symptoms-causes/syc-20350260 & at curehht.org