• R.I. CARCALICI Emergency Academic Hospital Sibiu
  • Corina ROMAN-FILIP Emergency Academic Hospital Sibiu


Periventricular nodular heterotopia (PNH) is among the most frequent malformations of cortical development due to disturbance in neuronal migration and is associated with intractable epilepsy. Neuronal migration disorders cause severe syndromes, including refractory epilepsy and major psychomotor development disorders. It has been demonstrating that approximately  80% of familial cases of PNH are related to FLNA mutation, gene located on the long arm of the X-chromosome inherited in a dominant fashion. A constellation of syndromes, including heterotopic nodules with intractable epilepsy, microcephaly, and severe develop-mental delay is seen in ARFGEF2 mutations, a gene located in chromosome 20 with an autosomal recessive inheritance pattern. We present a case of 18-years old patient, right-handed, without   remarkable findings in personal history of childhood, with normal social and psychiatric development. At the age of 15 she was admitted in the department of Psychiatry for depression and behavioral disorder (irritability and aggressive behavior) and she was treated with selective serotonin reuptake inhibitors (this happens frequently showed a small study which revealed that EEG can be abnormal in patients with neurotic disorders.

Author Biographies

R.I. CARCALICI, Emergency Academic Hospital Sibiu

Department of Neurology

Corina ROMAN-FILIP, Emergency Academic Hospital Sibiu

Department of Neurology 
“Lucian Blaga” University of Sibiu


1. Roceanu A, Bajenaru O. Periventricular nodular heterotopia in adult with temporal epilepsy, Rom J Leg Med 2012; 20(3): 207-210.
2. Passarelli V, Moreira CH., Periventricular nodular heterotopia: pathogenesis, epileptogenesis and implications in higher cerebral functions, Molecular & Cellular Epilepsy 2014; 1: e20.
3. Watrin F, Manent JB, Cardoso C, Represa C. Causes and Consequences of Gray Matter Heterotopia. CNS Neuroscience & Therapeutics 2015; 21: 112-122.
4. Christodoulou JA, Barnard ME, Del Tufo SN. Integration of gray matter nodules into functional cortical circuits in periventricular heterotopia. Epilepsy & Behavior 2013; 29: 400-406.
5. Kitaura H, Oishi H, Takei N, Fu YJ. Periventricular nodular heterotopia functionally couples with the overlying hippocampus. Epilepsia 2012; 53(7): e127-e131.
6. Aghakhani Y, Kinay D, Gotman J. The role of periventricular nodular heterotopia in epileptogenesis. Brain 2005; 128: 641-651.
7. Christodoulou JA, Walker LM, Del Tufo SN. Abnormal structural and functional brain connectivity in gray matter heterotopia. Epilepsia 2012; 53(6): 1024-1032.
8. Pizzo F, Roehri N, Catenoix H. Epileptogenic networks in nodular heterotopia: A stereo electroen-cephalography study. Epilepsia 2017; 58(12): 2112-2123.
9. Valton L, Guye M, McGonigal A. Functional interactions in brain networks underlying epileptic seizures in bilateral diffuse periventricular heterotopia, Clinical Neurophysiology 2008; 119: 212-223.
10. Popescu CE, Mai R, Sara R. The Role of FDG-PET in Patients with Epilepsy Related to Periventricular Nodular Heterotopias: Diagnostic Features and Long-Term Outcome, Journal of Neuroimaging 2019, https://doi.org/10.1111/jon.12620.
11. Mirandola L, Mai R, Francione S. Stereo-EEG: Diagnostic and therapeutic tool for periventricular nodular heterotopia epilepsies, Epilepsia 2017; 58(11): 1962-1971.
12. Constantinescu V, Matei D, Constantinescu I, Cuciureanu DI. Heart Rate Variability and Vagus Nerve Stimulation in Epilepsy Patients, Transl Neurosci 2019; 10: 223-232.
13. Roman-Filip C, Ungureanu A, Gligor F, Gabriela F. Painful tonic spasms and brainstem involvement in a patient with neuromyelitis optica spectrum disorders. Neurologia I Neurochirurgia Polska 2016; 50 (1): 55-58.
14. Ungureanu A, Rus LL, Gligor F, Lazaroae A, Prodan L, Roman-Filip C. Intravenous levetiracetam as second line option for status epilepticus, Farmacia 2016; 64(4): 507-511.