Assessment of gray matter heterotopia by magnetic resonance imaging.

AIM: To evaluate magnetic resonance imaging (MRI) features of different types of gray matter heterotopia. METHODS: Between June 2005 and December 2009, the medical records and MRI studies of patients with gray matter heterotopia were reviewed. The MRI morphologic findings of heterotopia were recorded along with the presence and type of associated cranial malformations. Available clinical and electrophysiological data were also recorded. RESULTS: 20 patients were included in the study. Their ages ranged from 9 mo to 39 years with a mean age of 15 years. All patients suffered from epileptic seizures. According to the location of heterotopia, patients were classified into three groups: subependymal (12), subcortical (5) and band (3) heterotopia. CONCLUSION: MRI was useful in diagnosing and differentiating between various types of gray matter heterotopia. The severity of clinical manifestations of heterotopia was related to the location and pattern of heterotopia. Determination of heterotopia type and its extent is useful for management planning and predicting prognosis.

Newly diagnosed seizures in adults.

OBJECTIVE: To study the clinical, electroencephalographic (EEG) and computed tomography (CT) profile in a hospital population of over 18-years adult patients with newly diagnosed recurrent seizures. METHODS: The clinical profiles obtained from history including detailed description of the seizures, examination, EEG and CT findings were recorded prospectively for all over-18 patients who were referred to the electrodiagnostic service at King Fahd Hospital of the University, Al-Khobar, Eastern Province, Kingdom of Saudi Arabia from January 1, 1996 to December 31, 1997. The data was entered into a standard database file and analyzed using a personal computer. RESULTS: Seventy-three patients (43 males, 30 females, mean age 32.3 years) with newly diagnosed recurrent seizures were studied. A positive family history of seizures was found in 12.3%. The main seizure types were partial in 27 (37%), partial with secondary generalization in 22 (30.1%) and generalized in 24 (32.9%). The types of epileptic syndromes included localization-related 34 (46.6%), generalized 24 (32.9%) and undetermined 15 (20.5%). The EEG was abnormal in 45 (61.6%) with epileptiform activity, focal in 22 (48.9%), generalized in 11 (24.4%) and non-epileptiform activity in 12 (26.7%). The cranial CT findings were normal in 44 patients (60.3%) and abnormal in 29 (39.7%) patients, with focal lesions in 19 (65.5%) and generalized cerebral atrophy in 10 (34.5%). CONCLUSION: Our results showed that partial and partial with secondary generalization seizures are the most frequent seizure type and the most common epileptic syndrome was the localization-related type in this age group. These results are comparable to previous population- and hospital-based western reports.