Grey matter hypertropia in a child with recurrent seizure: A case report

Heterotopia is a common anomaly of cortical development often associated with early-onset and familial epilepsy. Grey matter heterotopias are macroscopically classified into nodular and diffuse types and clinically categorized as subependymal, subcortical, or band heterotopia. They are frequently associated with other neurological conditions, such as corpus callosum agenesis, pachygyria, schizencephaly, polymicrogyria, Chiari II malformation, and basilar cephalocele. The clinical presentation varies depending on the thickness of the arrested neuronal band, ranging from partial complex and atypical absence epilepsy to normal cognitive function, developmental delay, or severe intellectual disability. Magnetic resonance imaging (MRI) is the preferred diagnostic modality, as it reveals the abnormally located heterotopic grey matter within the white matter. Carbamazepine is the most commonly prescribed antiepileptic drug, but its use depends on patient-specific factors such as tolerance, side effects, and efficacy. Here, we report the case of a 7-year-old male with a history of three seizure episodes over the past three years, initially diagnosed as febrile seizures with atypical focal features.