Abstracts

Rationale: The aim of the study was to evaluate prognostic factors in epileptic patients with Periventricular Nodular Heterotopia (PNH) identified by MRI.Methods: We selected 19 PNH patients. They were classified into 2 groups: G1, patients with good response to the pharmacological treatment and G2, refractory patients. We analyzed: average age (AA), age at onset of the epilepsy (AO), perinatal history (PH), annual seizure frequency (ASF), localization of the ictal symptomatogenic zone (LISZ), epileptiform abnormalities (EA) on the EEG, localization of the PNH and other abnormalities associated on the MRI (AAMRI).Results: G1 (n=11): 7 women (63.6 %), AA 28.2 ± 10.2 years (range 15-44), AO 13.7 ± 6.8 years (range 2-21), 2 patients (18.1%) with PH, ASF 30.7 ± 34.7 (range 0-120). LISZ: temporal in 5 patients (45.4%) and multifocal in 3 (27.2%). Eight patients (72.7%) showed an abnormal EEG, and 5 (62.5%) of them with EA. In 6 cases (54.6%) PNH was diffuse and in 5 (45.4%) focal. In 7 patients AAMRI (63.6%) were observed but anybody showed hippocampal sclerosis (HS). G2 (n=8): 6 women (75%), AA 36.8 ± 16 years (range 18-59), AO 12.7 ± 8.7 years (range 1-23), 3 cases (37.5%) with PH, ASF 135.7 ± 251.4 (range 24-750). LISZ: temporal in all the patients (100%) and multifocal in 4 (50%). All the cases (100%) showed an abnormal EEG and 7 (87.5%) of them with EA. In 3 cases (37.5%) PNH was diffuse and in 5 (62.5%) focal. In 6 patients (75%) were observed AAMRI, 4 cases associated with HS (dual pathology). The LISZ in the temporal lobe (p=0.01 - OR 2.2 CI 1.1-4.2) and the presence of HS in PNH patients (p= 0.01 – OR 3.7 CI 1.6-8.6) were more frequent in G2. There were no significant differences in the rest of the variables analyzed.Conclusions: The LISZ in the temporal lobe and the occurrence of dual pathology were associated with bad response to the pharmacological treatment in PNH patients.