Periventricular nodular heterotopia (PVNH) is an uncommon cause of refractory focal epilepsy caused by impaired neuronal migration from the ventricular system. This case series explains how MR-guided laser interstitial thermal ablation was used to treat children with PVNH-related epilepsy. Patients with PVNH-related epilepsy who had MR-guided laser interstitial thermal treatment (MRgLITT) at a single facility were identified. The results of preoperative and postoperative seizures, as well as procedural information, were assessed.
Five children with PVNH treated with MRgLITT were evaluated. Three of the patients were women, with a median age of 10.9 years. Stereoelectroencephalography phase II monitoring was used to precede five of the six treatments. Three of the youngsters had unilateral PVNH, whereas the other two had bilateral seizures. During phase II monitoring, the median number of attacks was 2; the median number of ablation targets was 2 (range 1–4). All of the patients had fewer seizures, and four (80%) had an Engel class ≤ III at the last follow-up (range I–IV). Following treatment, one youngster developed right hemianopia. This case series study has demonstrated a novel, minimally invasive technique for treating children with PVNH-related epilepsy. More research on this approach, as well as comparisons to other surgical procedures, is needed.