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Magnetic resonance imaging features of isolated periventricular heterotopia in pediatric epilepsy: a comparative study. Epileptic Disord 2022 Oct 01;24(5):795-802

Date

07/07/2022

Pubmed ID

35792848

DOI

10.1684/epd.2022.1450

Scopus ID

2-s2.0-85134360964 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

OBJECTIVE: Periventricular nodular heterotopia is a neurodevelopmental disorder in which neurons fail to migrate to the cortical surface, forming discrete areas of grey matter adjacent to the lateral ventricles. Given that periventricular nodular heterotopia is seen as an incidental finding in patients without epilepsy, causality between periventricular nodular heterotopia and epilepsy cannot be assumed. Furthermore, the structural characteristics of periventricular nodular heterotopia in patients with epilepsy are poorly defined and can be misleading. In this article, we investigate whether structural radiological characteristics of heterotopia can predict epileptogenicity in pediatric patients.

METHODS: Pediatric patients with periventricular nodular heterotopia, but no other epilepsy-associated cortical abnormalities on magnetic resonance imaging, were identified and divided into two groups: with epilepsy and without epilepsy. Radiological characteristics of laterality, regionalization, largest dimension and number of nodules were compared between the two groups.

RESULTS: Only periventricular nodular heterotopia spreading across several regions was associated with a statistically higher chance of epilepsy. Other features including laterality, individual region, number and largest dimension did not reliably predict epileptogenicity.

SIGNIFICANCE: Most radiological characteristics of periventricular nodular heterotopia are similar in patients with and without epilepsy. The involvement of multiple periventricular regions with heterotopia was the only feature that inferred a higher risk of epilepsy. Periventricular nodular heterotopia requires a comprehensive work-up and should be interpreted in the context of each individual patient and not assumed to be directly causative of epilepsy, nor unrelated to it. Therefore, further studies using additional structural and functional imaging modalities are needed to determine the radiological features of epileptogenic periventricular nodular heterotopia.

Author List

Tittle BJ, Maheshwari M, Marashly A

Author

Mohit Maheshwari MD Professor in the Radiology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Child
Choristoma
Epilepsy
Humans
Magnetic Resonance Imaging
Malformations of Cortical Development, Group II
Periventricular Nodular Heterotopia