[A patient with gigantic heterotopic gray matter with epileptic seizures].
We report a patient with partial seizure and gigantic heterotopic gray matter. A 23-year-old young man was admitted to our hospital with complaints of frequent epileptic seizures and psychiatric symptoms. There was psychomotor delay in infancy. At the age of 4 years, afebrile convulsions appeared on several occasions. Seizures characterized by a lapse of consciousness started at the age of 13 years. He often stayed in a fantasy world and became very emotional at such time. Cranial CT demonstrated an irregularity in the wall of right lateral ventricle and disappearance of the posterior horn on the same side. This lesion, adjacent to that wall, had a signal intensity that was similar to that of the gray matter on each sequence in MRI. Histopathology of this lesion showed a number of large and small neurons. Therefore, heterotopic gray matter was diagnosed. MRI demonstrated wide cortices suggesting polymicrogyria in the right parietal lobe. Complex partial seizures with eye deviation to the left were recognized. Interictal EEG showed frequent high voltage spikes in the right temporal, fronto-temporal and parieto-occipital areas independently. Therefore, epileptic foci were thought to exist in or around those lesions.
Hisano
T
T
National Center Hospital for Mental, Nervous and Muscular Disorders, Tokyo, Japan.
Takashima
S
S
Onuma
T
T
Muraoka
I
I
Adachi
N
N
Yoshino
A
A
Ishida
S
S
D000328:Adult; D001921:Brain; D002551:Cerebral Ventricle Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D002828:Choristoma / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D004827:Epilepsy / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009417:Nerve Tissue