Presentation
Long history of epilepsy.
Patient Data
Selected images demonstrate an ovoid well defined focal lesion is seen abutting the frontal horn of left lateral ventricle. The lesion is isointense to cortical grey matter on all sequences. There is no surrounding white matter edema. A thin CSF intensity line is seen radiating from the lesion towards the adjoining cortex, likely representing a prominent perivascular space.
Case Discussion
The patient has history of complex partial seizures from past 15 years. EEG has shown abnormal discharges in the left fronto-temporal region.
MRI brain shows focal unilateral grey matter heterotopia in left frontal region. No other associated anomaly was seen.
Seizures are seen in 80-90% cases of grey matter heterotopia.