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Symptomatic Absence Seizure and ESES; Thalamic Heterotopia. A 6-year-old boy with intractable symptomatic absence epilepsy and cognitive
dysfunction caused by right thalamic heterotopia (arrow). Complete resection of the heterotopia results in seizure freedom.
Alterations in normal thalamocortical reciprocal interactions are critical in the generation of the regular generalized spike-wave discharges characteristic of
the idiopathic generalized epilepsies.196
Most patients with unilateral thalamic lesion and epilepsy showed bilateral synchronous GSW discharges.191–195 Absence status with bilateral GSW
discharges caused
ischemic
lesion
in the
left thalamus
Source:by
Focal
Epilepsy,
Atlas
of Pediatric
EEG has been reported.192 Children with thalamic lesions should be monitored closely for ESES.
Lesions of the
inferior-medial-posterior
thalamic
structures
a role
the pathogenesis of bilateral
spike-wave
Citation:
Laoprasert P. Atlas
of Pediatric
EEG;might
2011 have
Available
at:inhttp://mhmedical.com/
Accessed:
May 14, (SW)
2017 discharges and ESES by the
193
mechanism of
disinhibition,
possibly
through
the
GABAergic
system
of
zona
incerta
and
its
projections.
Copyright © 2017 McGraw-Hill Education. All rights reserved
Gray matter heterotopias are caused by a halt in neuronal radial migration and consist of clusters of neurons separated from the cortex by white matter
and not organized in layers like the normal cortex.197 Although gray matter heterotopia is commonly associated with refractory epilepsy, it is still uncertain