Presentation
The most common clinical presentation is intractable seizures. Heterotopia present as nodular foci of grey matter intensity on all sequences. They do not enhance. Heterotopia Images of a typical subependymal heterotopia. [radiologyassistant.nl]
There were 7 patients (27.6%) who presented with hemorrhage (either intraparenchymal or subarachnoid), whereas the major presentation was venous congestion with edema ( Figure 5 ). [stroke.ahajournals.org]
Patients with isolated subependymal heterotopia usually present with a seizure disorder in the second decade of life. Subependymal heterotopia present in a wide array of variations. [en.wikipedia.org]
We present a case of a 1-year-old Hispanic girl with TSC in which bilateral cortical blindness is documented. [egms.de]
Patients usually present with intractable seizures. [ajnr.org]
Entire Body System
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Inflammation
This observation may argue against the hypothesis that inflammation alone may underlie the epileptogenicity of the tuber. [journals.plos.org]
607115 606416 Autosomal dominant NLRP3 1q44 Familial cold-induced inflammatory syndrome 1 120100 606416 Autosomal dominant NLRP3 1q44 Muckle-Wells syndrome 191900 606416 Autosomal dominant NLRP3 1q44 Deafness, autosomal dominant 34, with or without inflammation [mnglabs.com]
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Poor Feeding
Children with classic LIS often appear normal as newborns but may present with apnea, poor feeding, or hypotonia. [neupsykey.com]
Respiratoric
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Respiratory Distress
distress, and dysphagia, early-onset, mild variant 614399 612453 Autosomal recessive METTL23 17q25.1 Mental retardation, autosomal recessive 44 615942 615262 Autosomal recessive MFN2 1p36.22 Charcot-Marie-Tooth disease, axonal, type 2A2A 609260 608507 [mnglabs.com]
Gastrointestinal
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Dysphagia
613443 600662 Autosomal dominant MEFV 16p13.3 Familial Mediterranean fever, AR 249100 608107 Autosomal recessive MEFV 16p13.3 Familial Mediterranean fever, AD 134610 608107 Autosomal dominant MEGF10 5q23.2 Myopathy, areflexia, respiratory distress, and dysphagia [mnglabs.com]
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Dysphagia
613443 600662 Autosomal dominant MEFV 16p13.3 Familial Mediterranean fever, AR 249100 608107 Autosomal recessive MEFV 16p13.3 Familial Mediterranean fever, AD 134610 608107 Autosomal dominant MEGF10 5q23.2 Myopathy, areflexia, respiratory distress, and dysphagia [mnglabs.com]
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Failure to Thrive
Children in this group present with severe ID, spastic quadriparesis, gastroesophageal reflux, and poor feeding, leading to failure to thrive. Early-onset intractable epilepsy is common. Brain MRI universally shows a simplified gyral pattern. [neupsykey.com]
Neurologic
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Focal Neurological Deficit
The most common clinical sequelae of FCD are seizures, ID, and focal neurologic deficits. Epilepsy is usually focal, intractable, and often complicated by focal status epilepticus. [neupsykey.com]
Developmental delay, cognitive disability, and focal neurological deficits are only observed with extensive dysplasias. Early seizure onset has been associated with infantile spasms with asymmetrical or focal features [Guerrini and Filippi, 2005]. [karger.com]
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Learning Difficulties
However they may be associated with learning difficulties or seizures. Many will be discovered on magnetic resonance imaging of the brain. [jnnp.bmj.com]
Variant c.5494G A/p.Ala1832Thr occurred de novo in patient 7 with nonlesional occipital lobe epilepsy, macrocephaly, learning difficulties, and attention-deficit/hyperactivity disorder (ADHD). [ng.neurology.org]
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Speech Disorder
disorder and with or without mental retardation 245570 138253 Autosomal dominant GRIN2B 12p13.1 Mental retardation, autosomal dominant 6 613970 138252 Autosomal dominant GRIN2B 12p13.1 Epileptic encephalopathy, early infantile, 27 616139 138252 Autosomal [mnglabs.com]
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Language Delays
[…] somatic, mosaic 163000 600998 GNB4 3q26.33 Charcot-Marie-Tooth disease, dominant intermediate F 615185 610863 Autosomal dominant GNB5 15q21.2 Intellectual developmental disorder with cardiac arrhythmia 617173 604447 Autosomal recessive GNB5 15q21.2 Language [mnglabs.com]
Workup
This requires extensive workup with detailed brain imaging and EEGs. A neurosurgeon will then surgically remove the area of the brain that is causing the seizures. This is called epilepsy surgery. [childneurologyfoundation.org]
In our opinion, thrombotic complications of DVAs require the same treatment and laboratory workup as cortical venous or sinus thrombosis, ie, anticoagulation treatment with investigation of procoagulating factors or prothrombotic conditions. 58 Although [stroke.ahajournals.org]
Treatment
Food and Drug Administration has chosen Wave Life Sciences’ planned phase 2/3 study of suvodirsen, its lead experimental therapy for the treatment of Duchenne muscular dystrophy, to break new ground. [globalgenes.org]
liver and metabolic tests, drugs used, response to treatment, and final outcome. [bioline.org.br]
Your doctor will then talk with you about a few other treatment options. What other treatment options are there? Epilepsy surgery, vagus nerve stimulator (VNS), and ketogenic diet are some treatment options available if medications have failed. [childneurologyfoundation.org]
[…] underwent decompressive treatment with excellent results 32–34 ( Figure 2 ). [stroke.ahajournals.org]
Prognosis
OS has a poor prognosis. [bioline.org.br]
The careful assessment of patients with these abnormalities is important in order to provide an accurate prognosis and genetic counselling. [jnnp.bmj.com]
Causes and Prognosis [ edit ] In general, gray matter heterotopia is fixed in both its occurrence and symptoms; that is, once symptoms occur, it does not tend to progress. [en.wikipedia.org]
PROGNOSIS What is the outcome with treatment? About 60 to 70% of children will stop having seizures after treatment with one AED. Response to therapy depends a great deal on the seizure type and the cause for the epilepsy. [childneurologyfoundation.org]
Table 26.2 Genetic Etiologies of Malformations of Cortical Development Accurate diagnosis of MCD relies primarily on recognition of the malformation on brain MRI, which, in turn, determines correct prognosis and genetic counseling. [neupsykey.com]
Etiology
Etiologically, OS is usually based on static organic brain lesions including brain malformations which neuroimagings demonstrate, namely static encephalopathy. [bioline.org.br]
MTS is the most common cause of partial complex epilepsy in adults and is also the most common etiology in young adult patients undergoing surgery. [radiologyassistant.nl]
Table 26.2 Genetic Etiologies of Malformations of Cortical Development Accurate diagnosis of MCD relies primarily on recognition of the malformation on brain MRI, which, in turn, determines correct prognosis and genetic counseling. [neupsykey.com]
Cerebral venous angiomas: clinical evaluation and possible etiology. Radiology. 1981 ; 139 : 87–94. Crossref Medline Google Scholar 37 Huber G, Piepgras U, Henkes H, Faubert C. Venous anomalies of the brain. [stroke.ahajournals.org]
These schemes, however, were established to distinguish distinct entities considering clearly different clinical etiologies. [journals.plos.org]
Epidemiology
Relevant External Links for KIF5C Genetic Association Database (GAD) KIF5C Human Genome Epidemiology (HuGE) Navigator KIF5C Atlas of Genetics and Cytogenetics in Oncology and Haematology: KIF5C No data available for Genatlas for KIF5C Gene Personalized [genecards.org]
Neurology 76: 1548–1554 Google Scholar Kaderali Z, Lamberti-Pasculli M, Rutka JT (2009) The changing epidemiology of paediatric brain tumours: a review from the Hospital for Sick Children. [link.springer.com]
Epidemiology Neural tube defects (NTDs) are among the most common congenital abnormalities but prevalence varies between countries and races. [jnnp.bmj.com]
Most series described the epidemiology, distribution, radiological characteristics, and associated conditions of DVAs. [stroke.ahajournals.org]
Tinkle BT, Schorry EK, Franz DN, Crone KR, Saal HM: Epidemiology of hemimegalencephaly: a case series and review. Am J Med Genet A 139:204-211 (2005). [karger.com]
Pathophysiology
Pathophysiology This syndrome is one of the age–dependent epileptic reactions to various non-specific exogenous brain insults acting at the specific developmental stages. 5 The pathophysiological mechanism of S-B is not clarified. 9 Spreafico et al. suspected [bioline.org.br]
Despite this limitation, it was possible to address several aspects that relate to pathophysiological mechanisms in tubers. [journals.plos.org]
Based on the imaging features and clinical symptoms, 2 major groups of presumed pathophysiological mechanisms could be identified: mechanical and flow-related. [stroke.ahajournals.org]
Prevention
PREVENTION Seizures can be prevented by regularly taking the prescribed medications. In fact, not taking medications is the most common cause for breakthrough seizures. During times of illness or stress, seizures can occur. [childneurologyfoundation.org]
Following this line of thought, there is in our practice a place for preventive treatment in an asymptomatic patient with a shunt draining through a DVA. [stroke.ahajournals.org]
Fox JW, Lamperti ED, Ekşioğlu YZ, Hong SE, Feng Y, et al: Mutations in filamin 1 prevent migration of cerebral cortical neurons in human periventricular heterotopia. Neuron 21:1315-1325 (1998). [karger.com]