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Invasive EEG in Grey Matter Heterotopia 

Invasive EEG in Grey Matter Heterotopia
Invasive EEG in Grey Matter Heterotopia

Roberto Mai

, and Laura Tassi

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date: 11 July 2020

Grey matter heterotopias (GMH) are in the malformations of cortical development group of disorders, comprising an entity of abnormal neuronal migration, triggering patterns of cortical and neuronal disarrangement. Normal but misplaced tissue within the original organ characterizes heterotopias. They share the same signal intensity as adjacent cortical grey matter, are bilateral or unilateral, diffuse or localized, with subependymal, subcortical, or transmantle localization. Genetic causes are common, particularly in bilateral cases. Drug-resistant epilepsy is the main symptom; surgery should be planned early. Invasive recordings are considered mandatory, and stereo-EEG is the most suitable exploration methodology. Both GMH and surrounding cortices may originate discharges. Surgery demonstrates good results, especially when a lesionectomy (even when incomplete) is associated with a corticectomy. Recently, thermocoagulation of the GMH and cortices encompassed within the epileptogenic zone has provided a therapeutic approach in selected, even bilateral, cases. Laser interstitial thermal therapy needs further evaluation in these patients.

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