Technical case report: intractable focal seizures related to bifrontal transmantle heterotopia subserving peculiar homotopic motor distribution treated by responsive neurostimulation therapy

Authors

Ross-Jordon S. Elliott, Department of Neurological Surgery, The George Washington University Hospital, 900 23rd Street NW, Washington, DC, 20037, USA.
Tiffany N. Phan, Division of Neurosurgery, Children's National Hospital, 111 Michigan Avenue NW, Washington, DC, 20010, USA.
Chima O. Oluigbo, Division of Neurosurgery, Children's National Hospital, 111 Michigan Avenue NW, Washington, DC, 20010, USA. COluigbo@cnmc.org.

Document Type

Journal Article

Publication Date

4-12-2022

Journal

Acta neurochirurgica

DOI

10.1007/s00701-022-05193-y

Keywords

Case report; Heterotopia; Intractable epilepsy; Responsive neurostimulation (RNS)

Abstract

NeuroPace responsive neurostimulation (RNS) therapy was used in a case of intractable focal epilepsy with bifrontal transmantle heterotopia subserving peculiar homotopic motor distribution in a 16-year-old, right-handed male with intractable seizures. Brain MRI demonstrated bifrontal transmantle heterotopia extending from the central sulcus to subjacent lateral ventricles along with polymicrogyria along the overlying cortex suspected to be the motor cortex. Functional MRI demonstrated homotopic distribution of finger and foot motor function (deeper) within the polymicrogyria. Invasive intracranial monitoring with depth electrodes and extraoperative brain mapping revealed eloquent cortical tissue which corresponded to the right leg and right shoulder motor function.

APA Citation

Elliott, Ross-Jordon S.; Phan, Tiffany N.; and Oluigbo, Chima O., "Technical case report: intractable focal seizures related to bifrontal transmantle heterotopia subserving peculiar homotopic motor distribution treated by responsive neurostimulation therapy" (2022). GW Authored Works. Paper 798.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/798

Department

Neurological Surgery