ABSTRACT

Heterotopia, referred to as a limited or common neuronal migration disorder, may manifest clinically with mild mental retardation, epileptic seizures, psychiatric symptoms, or systemic disorders. Approximately 90% of cases have drug-resistant epileptic seizures. Lennox-Gastaut syndrome (LGS) is an epileptic encephalopathy with cognitive impairment; it is treatment-resistant and has a poor prognosis, with multiple patterns of seizures and specific electroencephalographic (EEG) patterns. In this case, the brain imaging showed band heterotopy, an EEG 2–2.5 Hz spike wave, and multiple spike and fast rhythms. This case of a 17-year-old male patient with drug-resistant tonic, atonic, myoclonic, atypical absence seizures, and behavioral abnormalities who was diagnosed with LGS was presented to highlight the difficulty in treatment management.