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Treatment of Epilepsy Associated with Periventricular Nodular Heterotopia

  • Epilepsy (C.W. Bazil, Section Editor)
  • Published:
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Abstract

Purpose of Review

Epilepsy associated with periventricular nodular heterotopia (PNH), a developmental malformation, is frequently drug-resistant and requires focal therapeutic intervention. Invasive EEG study is usually necessary to delineate the epileptogenic zone, but constructing an accurate hypothesis to define an appropriate electrode implantation scheme and the treatment is challenging. This article reviews recent studies that help understanding the epileptogenicity and potential therapeutic options in PNH.

Recent Findings

New noninvasive diagnostic and intracerebral EEG analytic tools demonstrated that cortical hyperexcitability and aberrant connectivity (between nodules and cortices and among nodules) are likely mechanisms causing epilepsy in most patients. The deeply seated PNH, if epileptogenic, are ideal target for stereotactic ablative techniques, which offer concomitant ablation of multiple regions with relatively satisfactory seizure outcome.

Summary

Advance in diagnostic and analytic tools have enhanced our understanding of the complex epileptogenicity in PNH. Development in stereotactic ablative techniques now offers promising therapeutic options for these patients.

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Authors and Affiliations

  1. Department of Neurosurgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita-shi, Osaka Prefecture, 565-0871, Japan

    Hui Ming Khoo

  2. Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, QC, H3A 2B4, Canada

    Jean Gotman, Jeffery A. Hall & François Dubeau

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  1. Hui Ming Khoo
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  2. Jean Gotman
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Correspondence to Hui Ming Khoo.

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Hui Ming Khoo, Jean Gotman, Jeffery A. Hall, and François Dubeau declare that they have no conflict of interest.

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This article is part of the Topical Collection on Epilepsy

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Khoo, H.M., Gotman, J., Hall, J.A. et al. Treatment of Epilepsy Associated with Periventricular Nodular Heterotopia. Curr Neurol Neurosci Rep 20, 59 (2020). https://doi.org/10.1007/s11910-020-01082-y

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