Epileptic Disorders


Intracranial investigation of a patient with nodular heterotopia and hippocampal sclerosis: dealing with a dual pathology Volume 19, issue 2, June 2017


(1) In patients with intractable epilepsy and nodular heterotopias, which of the following is true regarding ictal activity?

A. Ictal activity can start from the nodules.

B. Ictal activity can start from the overlying or distant cortex.

C. In patients with dual pathology, ictal activity can start simultaneously in the heterotopic nodules, but also in other pathological lesions, such as those associated with hippocampal sclerosis or DNET.

D. All the answers are true.


(2) Which is the best predictor of seizure freedom in cases with nodular heterotopia?

A. The detection of a focal epileptic generator by intracranial recording.

B. The detection of a clear MRI lesion.

C. The resection of the entire malformation of cortical development.

D. The confirmation of nodular heterotopia based on the pathological findings.


(3) The recommendation for patients with nodular heterotopia associated with hippocampal sclerosis in the same hemisphere is:

A. To always remove the entire nodular heterotopia.

B. To always remove the entire nodular heterotopia and the hippocampal lesion.

C. To remove the epileptogenic area guided by the results of the intracranial recording.

D. To remove the entire nodular heterotopia and the overlying cortex.



See answers






















(1) D.

(2) A.


(3) C.


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