Treatment of Epilepsy Associated with Periventricular Nodular Heterotopia

Khoo, Hui Ming; Gotman, Jean; Hall, Jeffery A.; Dubeau, François

doi:10.1007/s11910-020-01082-y

Cited by 20 publications

(36 citation statements)

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“…Gray matter clusters are seen in localizations that should not be in the brain. The incidence of epilepsy is very high in patients with gray matter heterotopia [11][12][13][14][15]. The most common subtype is SEH.…”

Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of Apparent Diffusion Coefficient Values of White Matter Surrounding the Heterotopia in Children With Unilateral Subependymal Heterotopia

Eroğlu¹,

Kara²

2022

Cureus

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Introduction: To compare the apparent diffusion coefficient (ADC) values of the white matter around heterotopia in children with unilateral subependymal heterotopia with those of the symmetrical normal cerebral hemisphere and control group.Methods: Between January 2011 and September 2021, 15 pediatric patients with unilateral focal subependymal heterotopia among 47 patients with heterotopia detected in brain magnetic resonance imaging (MRI) in our hospital were included in the study. The control group consisted of 15 age-and sexmatched children with normal neurological examination and normal brain MRI. In brain MRIs, ADC value was measured from the white matter around the heterotopia area and from the opposite cerebral hemisphere matched to the location, and from the bilateral location-matched white matter of the control group. The area of heterotopia was measured on axial T1-weighted MRI. The data were evaluated statistically.Results: There were eight girls and seven boys in the heterotopia group. The median age was 5.00 (min: 3, max: 14). There was no statistically significant difference between the ADC values of the heterotopia side and contralateral white matter of the heterotopia group. In addition, no statistically significant difference was found between the heterotopia side and opposite sides of the heterotopia and control groups ADC values.Conclusion: According to the findings of this study, no difference was found in the ADC values of the white matter around the lesion in children with subependymal heterotopia compared to the opposite cerebral hemisphere and control groups.

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Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of Apparent Diffusion Coefficient Values of White Matter Surrounding the Heterotopia in Children With Unilateral Subependymal Heterotopia

Eroğlu¹,

Kara²

2022

Cureus

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“…Seizures can therefore emerge from one or more nodules, areas of overlying cortex, or a complex network of interactions between nodules (eg, the overlying cortex and sometimes the hippocampus). 15 On MRI, the periventricular nodular heterotopias appear as solid masses isointense to gray matter lining the ventricular walls, sometimes with a ribbonlike morphology, usually in the anterior or posterior regions of the lateral ventricles; multiple heterotopias may be present in the same patient (FIGURE [3][4][5][6][7]. Careful attention should also be paid to the overlying cortex for signs of focal cortical dysplasia.…”

Section: Periventricular Nodular Heterotopiamentioning

confidence: 99%

“…These lesions appear hypointense on T1-weighted and T2-weighted MRI sequences. T2* sequences reveal a strongly hypointense blooming artifact (FIGURE [3][4][5][6][7][8][9][10][11][12][13][14][15][16].…”

Section: Neurocysticercosismentioning

confidence: 99%

“…Various methods of automated texture analysis may be used to quantitatively evaluate and visually enhance the MRI correlates of focal cortical dysplasia, such as blurring of the gray-white matter or alterations in the intensity of gray matter signal. Depending on the sensitivity of the algorithm, multiple areas of potential abnormality can be expressed visually and correlated with the patient's other clinical data to evaluate potential targets of intracranial EEG evaluation (FIGURE [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. The sulcogyral pattern is abnormal and includes many small gyri.…”

Section: Key Pointsmentioning

confidence: 99%

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Neuroimaging of Epilepsy

Lapalme-Remis¹,

Nguyen²

2022

CONTINUUM: Lifelong Learning in Neurology

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PURPOSE OF REVIEW:This article focuses on the evaluation of children and adults who present with new-onset seizures, with an emphasis on differential diagnosis, classification, evaluation, and management. RECENT FINDINGS:New-onset seizures are a common presentation in neurologic practice, affecting approximately 8% to 10% of the population. Accurate diagnosis relies on a careful history to exclude nonepileptic paroxysmal events. A new classification system was accepted in 2017 by the International League Against Epilepsy, which evaluates seizure type(s), epilepsy type, epilepsy syndrome, etiology, and comorbidities. Accurate classification informs the choice of investigations, treatment, and prognosis. Guidelines for neuroimaging and laboratory and genetic testing are summarized. SUMMARY:Accurate diagnosis and classification of first seizures and new-onset epilepsy are key to choosing optimal therapy to maximize seizure control and minimize comorbidities. KEY POINTS• Epilepsy is defined as any of the following: (1) at least two unprovoked (or reflex) seizures occurring more than 24 hours apart, (2) one unprovoked (or reflex) seizure and a probability of further seizures similar to the general recurrence risk (at least 60%) after two unprovoked seizures, occurring over the next 10 years, or (3) diagnosis of an epilepsy syndrome.• A careful history taken from both the patient as well as any witnesses to the event(s) is the most critical aspect in distinguishing a seizure from a nonepileptic paroxysmal event.• It is the first convulsive seizure that typically brings the patient to medical attention. Many people presenting with a "first seizure" have a history of prior seizures, which may not have been recognized, and thus have epilepsy.

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“…Modern epilepsy treatment mainly includes etiology treatment, drug treatment, surgical treatment, and other physical therapy (20). Studies have shown that patients with no clear cause or those who have a cause but the cause itself cannot be eradicated should receive aggressive drug treatment (21). The choice of treatment drugs should be based on the different types of seizures.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of lamotrigine after failure of the first administration of valproate in treating epilepsy: a systematic review and meta-analysis

He¹,

Wu²,

Dong³

2022

Ann Palliat Med

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Background: Epilepsy is a long-term recurrent chronic brain disease that can cause significant emotional burden to the patient and their family, as well as huge economic costs to society. Timely and accurate diagnosis of epilepsy, together with early and standardized treatments can effectively control seizures and restore the patient's quality of life and reduce the economic burden. This meta-analysis examined the efficacy of lamotrigine administration in patients with epilepsy.Methods: A literature search was performed in the PubMed, Embase, and OVID-Medline databases to identify articles related to epilepsy and lamotrigine that were published from the establishment of the database to April 2021. The keywords used for the literature search included "epilepsy", "sodium valproate", "lamotrigine", "effectiveness", and "therapeutic effect". It uses Cochrane review manual 5.3 to evaluate the quality of the included literature and review manager 5.3 software for meta-analysis.Results: A total of 9 studies involving 1,864 patients with epilepsy were included in this meta-analysis.The results revealed that, after treatment failure with the first drug of valproic acid, the total effective rate of lamotrigine treatment had an odds ratio (OR) of 2.21 with a 95% confidence interval (CI) of 1.15 to 4.27 (Z=2.37; P=0.02). The total adverse reaction rate (OR =0.70; 95% CI: 0.55 to 0.88; Z=2.98; P=0.003) and the improvement rate of epilepsy associated with lamotrigine treatment (OR =4.22; 95% CI: 1.00 to 17.84; Z=1.96; P=0.05) were all significantly higher than that of other drug treatments.Discussion: A total of 9 articles were included in this meta-analysis to examine the efficacy of lamotrigine in the treatment of epilepsy. The clinical efficacy of lamotrigine addition therapy was found to be superior to lamotrigine replacement therapy, and the incidence of adverse reactions was lower than that of lamotrigine replacement therapy. However, due to the low methodological quality of the included literatures, this conclusion should be further verified using large sample and high-quality randomized double-blinded experiments.

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Treatment of Epilepsy Associated with Periventricular Nodular Heterotopia

Cited by 20 publications

References 80 publications

Comparative Evaluation of Apparent Diffusion Coefficient Values of White Matter Surrounding the Heterotopia in Children With Unilateral Subependymal Heterotopia

Comparative Evaluation of Apparent Diffusion Coefficient Values of White Matter Surrounding the Heterotopia in Children With Unilateral Subependymal Heterotopia

Neuroimaging of Epilepsy

The efficacy of lamotrigine after failure of the first administration of valproate in treating epilepsy: a systematic review and meta-analysis

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