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Electroencephalographic Recordings of Focal Seizures in Patients Affected by Periventricular Nodular Heterotopia: Role of the Heterotopic Nodules in the Genesis of Epileptic Discharges

Division of Experimental Neurophysiology and Epileptology, Neurological Institute 'C' Besta, Milan Italy, battaglia{at}istituto-besta.it.

Silvana Franceschetti

Division of Clinical Neurophysiology, Neurological Institute 'C' Besta, Milan Italy

Luisa Chiapparini

Division of Neuroradiology, Neurological Institute 'C' Besta, Milan Italy

Elena Freri

Division of Child Neurology Neurological Insitute 'C'. Besta, Milan, Italy

Stefania Bassanini

Divisions of Experimental Neurophysiology and Epileptology, Neurological Institute 'C' Besta, Milan Italy

Alessio Giavazzi

Divisions of Experimental Neurophysiology and Epileptology, Neurological Institute 'C' Besta, Milan Italy

Adele Finardi

Divisions of Experimental Neurophysiology and Epileptology, Neurological Institute 'C' Besta, Milan Italy

Franco Taroni

Division of Biochemistry and Genetics Neurological Institute "C. Besta", Milan, Italy

Tiziana Granata

Division of Child Neurology Neurological Insitute 'C'. Besta, Milan, Italy

Patients affected by periventricular nodular heterotopia are frequently characterized by focal drug-resistant epilepsy. To investigate the role of periventricular nodules in the genesis of seizures, we analyzed the electroencephalographic (EEG) features of focal seizures recorded by means of video-EEG in 10 patients affected by different types of periventricular nodular heterotopia and followed for prolonged periods of time at the epilepsy center of our institute. The ictal EEG recordings with surface electrodes revealed common features in all patients: all seizures originated from the brain regions where the periventricular nodular heterotopia were located; EEG patterns recorded on the leads exploring the periventricular nodular heterotopia were very similar both at the onset and immediately after the seizure's end in all patients. Our data suggest that seizures are generated by abnormal anatomic circuitries, including the heterotopic nodules and adjacent cortical areas. The major role of heterotopic neurons in the genesis and propagation of epileptic discharges must be taken into account when planning surgery for epilepsy in patients with periventricular nodular heterotopia. (J Child Neurol 2005;20:369—377).

Journal of Child Neurology, Vol. 19, No. 3, 369-377 (2004)
DOI: 10.1177/08830738040190031701


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