Medical College of Wisconsin Ringgold standard institution - Pediatric Radiology Milwaukee, Wisconsin, USA
The Johns Hopkins Hospital Ringgold standard institution - Epilepsy Center Baltimore, Maryland, USA
Epileptic Disord. 2022 Oct 1;24(5):795-802. doi: 10.1684/epd.2022.1450.
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.
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.
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.
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.
室周结节性异位是一种神经发育障碍，其中神经元未能迁移到皮质表面，形成与侧脑室相邻的离散灰质区。鉴于室周结节性异位在无癫痫的患者中被视为偶发发现，因此不能假定室周结节性异位与癫痫之间存在因果关系。此外，癫痫患者室周结节性异位的结构特征定义不明确，可能具有误导性。在本文中，我们研究了异位的结构放射学特征是否可以预测儿科患者的致痫性。
确定了磁共振成像上无其他与癫痫相关皮质异常的室周结节性异位的儿科患者，并将其分为癫痫组和无癫痫组。比较两组之间的侧位、区域化、最大尺寸和结节数量的放射学特征。
只有跨越多个区域的室周结节性异位与癫痫发生的统计学上更高的可能性相关。其他特征，包括侧位、单个区域、数量和最大尺寸，不能可靠地预测致痫性。
大多数室周结节性异位的放射学特征在有癫痫和无癫痫的患者中相似。涉及多个室周区域的异位是唯一暗示癫痫风险更高的特征。室周结节性异位需要全面检查，应根据每个患者的具体情况进行解释，而不是假定其直接导致癫痫，也不是与癫痫无关。因此，需要进一步使用其他结构和功能成像方式的研究来确定致痫性室周结节性异位的放射学特征。
