Abstract
Aim
The aim of this study is to evaluate the correlation between clinical presentation and the extent of cortical involvement in patients with polymicrogyria.
Materials and methods
The magnetic resonance imaging findings of 26 patients were evaluated for the location and distribution of polymicrogyria. Presence of asphyxia at birth and serological tests for TORCH infections, the presence and type (spastic, flaccid) of motor deficits, mental development, microcephaly, and epilepsy were noted.
Results
Nineteen patients had bilateral, whereas seven had unilateral involvement. Patients with unilateral polymicrogyria presented later with milder symptoms. The most encountered symptom in patients with bilateral involvement was mental motor retardation (MMR) (89%) and speech problems (84%). The clinical presentations of patients with asphyxia and positive serological tests for cytomegalovirus (CMV) were worse. All patients with positive serological tests for CMV had bilateral involvement. The perisylvian region was affected in five (71%) patients with unilateral involvement. The most encountered presenting symptom in these patients was epilepsy. Cerebral palsy was seen in three (43%) of the patients, and all of them had left hemiparesis. Microcephaly, MMR, and speech delay were detected in one (14%) of the patients.
Conclusions
Late presenting epilepsy may be a predictor of a unilateral polymicrogyria and is associated with relatively good prognosis. CMV infection and the presence of asphyxia are predictors of worse prognosis.
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References
Pascual-Castroviejo I, Pascual-Pascual SI, Viaño J, Martinez V, Palencia R (2001) Unilateral polymicrogyria: a common cause of hemiplegia of prenatal origin. Brain Dev 23:216–222
Barkovich AJ, Hevner R, Guerrini R (1999) Syndromes of bilateral symmetrical polymicrogyria. AJNR Am J Neuroradiol 20:1814–1821
Hayakawa K, Kanda T, Yamori Y (2002) Unilateral cerebral polymicrogyria with ipsilateral cerebral hemiatrophy. Eur Radiol 12:2542–2547
Thompson JE, Castillo M, Thomas D, Smith MM, Mukherji SK (1997) Radiologic-pathologic correlation polymicrogyria. AJNR Am J Neuroradiol 18:307–312
Smith AS, Blaser SI, Ross JS, Weinstein MA (1989) Magnetic resonance imaging of disturbances in neuronal migration: illustration of an embryologic process. Radiographics 9:509–22
Sztriha L, Nork M (2000) Bilateral frontoparietal polymicrogyria and epilepsy. Pediatr Neurol 22:240–243
Caraballo RH, Cersósimo R, Mazza E, Fejerman N (2000) Focal polymicrogyria in mother and son. Brain Dev 22:336–339
Tombini M, Marciani MG, Romigi A, Izzi F, Sperli F, Bozzao A, Floris R, De Simone R, Placidi F (2003) Bilateral frontal polymicrogyria and epilepsy in a patient with Turner mosaicism: a case report. J Neurol Sci 213:83–86
Raybaud C, Canto-Morein N, Girard N, Poncet M (1995) Polymicrogyria. MR appearance and its relationship to the fetal development of the cortex and its microvasculature. Int J Neuroradiol 1:161–170
Hayashi N, Tsutsumi Y, Barkovich AJ (2002) Polymicrogyria without porencephaly/schizencephaly. MRI analysis of the spectrum and the prevalence of macroscopic findings in the clinical population. Neuroradiology 44:647–655
Guerrini R, Genton P, Bureau M, Parmeggiani A, Salas-Puig X, Santucci M, Bonanni P, Ambrosetto G, Dravet C (1998) Multilobar polymicrogyria, intractable drop attack seizures, and sleep-related electrical status epilepticus. Neurology 51:504–512
Guerrini R, Carrozzo R (2001) Epileptogenic brain malformations: clinical presentation, malformative patterns and indications for genetic testing. Seizure 10:532–543
Işik U, Dinçer A, Ozek MM (2007) Surgical treatment of polymicrogyria with advanced radiologic and neurophysiologic techniques. Childs Nerv Syst 23:443–448
Barkovich AJ, Kjos BO (1992) Nonlissencephalic cortical dysplasia: correlation of imaging findings with clinical deficits. AJNR Am J Neuroradiol 13:95–103
Jacobs KM, Hwang BJ, Prince DA (1999) Focal epileptogenesis in a rat model of polymicrogyria. J Neurophysiol 81:159–173
Bartolomei F, Gavaret M, Dravet C, Guye M, Bally-Berard JY, Genton P, Raybaud C, Régis J, Gastaut JL (1999) Late-onset epilepsy associated with regional brain cortical dysplasia. Eur Neurol 42:11–16
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Mavili, E., Coskun, A., Per, H. et al. Polymicrogyria: correlation of magnetic resonance imaging and clinical findings. Childs Nerv Syst 28, 905–909 (2012). https://doi.org/10.1007/s00381-012-1703-2
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DOI: https://doi.org/10.1007/s00381-012-1703-2