ILAE neuroimaging task force highlight: Subcortical laminar heterotopia

Epileptic Disord. 2024 Apr;26(2):225-232. doi: 10.1002/epd2.20206. Epub 2024 Feb 14.

Abstract

The ILAE Neuroimaging Task Force publishes educational case reports that highlight basic aspects of neuroimaging in epilepsy consistent with the ILAE's educational mission. Subcortical laminar heterotopia, also known as subcortical band heterotopia (SBH) or "double cortex," is an intriguing and rare congenital malformation of cortical development. SBH lesions are part of a continuum best designated as agyria-pachygyria-band-spectrum. The malformation is associated with epilepsy that is often refractory, as well as variable degrees of developmental delay. Moreover, in an increasing proportion of cases, a distinct molecular-genetic background can be found. Diagnosing SBH can be a major challenge for many reasons, including more subtle lesions, and "non-classic" or unusual MRI-appearances. By presenting an illustrative case, we address the challenges and needs of diagnosing and treating SBH patients in epilepsy, especially the value of high-resolution imaging and specialized MRI-protocols.

Keywords: double cortex; epilepsy; neuroimaging; subcortical band heterotopia; subcortical laminar heterotopia.

MeSH terms

  • Cerebral Cortex / pathology
  • Classical Lissencephalies and Subcortical Band Heterotopias* / diagnostic imaging
  • Epilepsy* / etiology
  • Humans
  • Magnetic Resonance Imaging
  • Neuroimaging