Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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March 3, 2008
Parahippocampal Gray Matter Heterotopias, Dysplastic Left Cerebellum
- Most common causes of recognizable hippocampal lesions causing seizures: sclerosis, developmental abnormalities (cortical dysplasias, gray matter heterotopias), vascular malformations (cavernous or arteriovenous malformations) or insults (infarctions), tumors (glial, oligodendroglial, ganglion cell)
- In one study, 7.2% of patients with temporal lobe epilepsy had malformations: heterotopia, neocortical malformation, abnormal shape/configuration and other complex malformations
- Parahippocampal heterotopias are amenable to surgery only when unilateral and not present elsewhere (patients who also have periventricular heterotopias will most likely have recurrent seizures)
- Regardless of underlying lesion, shortly after seizures (particularly prolonged ones) the hippocampi may be T2 bright and show restricted diffusion
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