Brain magnetic resonance spectroscopic imaging (1H-MRSI) in patients with large areas of subcortical heterotopia and epilepsy

We used proton magnetic resonance spectroscopic imaging in four patients with subcortical heterotopia (SH) and epilepsy with good seizure control. Three patients did not show significant metabolic abnormalities in correspondence with the lesions nor in the normal cortex. A reduction in the neuronal marker NAA within the lesion was found in the patient with the longest history of epilepsy and the major frequency of seizures. These preliminary findings suggest that the good prognosis of epilepsy and the absence of significant cognitive impairment in our patients are associated with a normal metabolic function of the SH cells.