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From the Division of Neurology, Department of Medicine (Drs. Kothare, VanLandingham, and Radtke), and Division of Neurosurgery, Department of Surgery (Dr. Friedman), Duke University Medical Center, Durham, NC; Department of Neurology (Dr. Armon), Loma Linda University School of Medicine, Loma Linda, CA; and SW Texas Methodist Hospital Comprehensive Epilepsy Center (Dr. Luther), San Antonio, TX.
Address correspondence and reprint requests to Dr. Rodney A. Radtke, Division of Neurology, Department of Medicine, Box 3678, Duke University Medical Center, Durham, NC 27710.
The association between gray matter heterotopias and seizures is well established; whether seizures originate from these lesions is not known. We evaluated three patients with intractable complex partial seizures and periventricular nodular heterotopias (PNHs) with video-EEG monitoring with multiple depth electrodes, including placement in the PNH, to determine whether seizures originate from the PNH. In two of the three patients, all seizures arose from the PNH as low-voltage beta activity. In the third patient, 80% arose from the hippocampi and 20% from the heterotopia. PNHs may serve as an epileptogenic focus in patients with intractable epilepsy.
Presented in part at the 50th annual meeting of the American Academy of Neurology, Minneapolis, MN, April 1998.
Received April 3, 1998. Accepted in final form August 15, 1998.
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