Subependymal grey matter heterotopia

Case contributed by Kamran Hajiyev
Diagnosis certain


First generalized tonic–clonic seizure. No other diseases.

Patient Data

Age: 30 years
Gender: Male

Periventricular subependymal nodules of grey matter in the right temporal lobe, lateral of the trigonum. The nodules follow grey matter on all sequences. No enhancing or diffusion restriction in the post contrast sequences. Polymicrogyric cortex of the right temporal lobe has also signal characteristics similar to normal grey matter. Incidental note is made of a arachnoid cyst of the left frontal fossa, temporopolar and retrocerebellar.

Follow-up-MRI after 30 months. Unchanged subependymal distribution of the grey matter heterotopia and Polymicrogyria in the right temporal lobe. No enhancing.

Case Discussion

Heterotopic grey matter is an abnormality of neuronal migration that has been reported in association with refractory epilepsy. Patients with heterotopia show a wide spectrum of clinical manifestations, from being asymptomatic to presenting with intractable seizures and intellectual impairment. Polymicrogyria is one of the congenital anomalies, that often associated with grey matter heterotopia.

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