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The migrational disorders are a rare group of congenital malformations of the brain. They consist of the following entities--lissencephaly (agyria-pachygyria), pachygyria, schizencephaly, heterotopia and polymicrogyria. We studied 40 children with migrational disorders radiologically with CT and MR. This article (part I) deals with our patients their characteristic CT and MR findings along with their clinical presentation and course. These patients presented with one or a combination of the following symptoms, hypotonia, seizures, failure to thrive, microcephaly and occasionally hydrocephalus. These two groups of migrational disorders have abnormalities affecting the gyral-sulcal pattern of the cortex and gray-white matter distribution of the brain. MR provided better delineation of these disorders than CT. Because some forms of the migrational disorders can be inherited, it is extremely important for the radiologist to understand the characteristic findings for correct diagnosis which is essential for parental counseling.
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PMID:The CT and MR evaluation of migrational disorders of the brain. Part I. Lissencephaly and pachygyria. 271 49

The migrational disorders are a rare group of congenital malformations of the brain. They consist of the following entities - lissencephaly (agyria - pachygyria), pachygyria, schizencephaly, heterotopia and polymicrogyria. We studied 40 children with migrational disorders radiologically with CT and MR. This article (Part II) deals with our patients with schizencephaly, heterotopia and polymicrogyria. These patients presented clinically with a variety of symptoms. The most common were seizures, delayed development, failure to thrive and hydrocephalus. CT and MR both demonstrated the characteristic findings in all of our patients except the polymicrogyria group. The gray matter and cleft abnormalities seen in these disorders were demonstrated with CT and MR. However, MR provided better delineation of these disorders than CT. Because some forms of migrational disorders can be inherited, it is extremely important for the radiologist to understand the characteristic findings for correct diagnosis which is essential for parental counseling.
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PMID:The CT and MR evaluation of migrational disorders of the brain. Part II. Schizencephaly, heterotopia and polymicrogyria. 274 27

From June. 1987 to Dec. 1988, data was collected from 12 cases with Congenital Brain Anomalies. The cases involved 7 girls and 5 boys with ages ranging from 2 days to 15 years old. Abnormalities diagnosed were Cavum-septi pellucidi; Cavum vergae; Cystic dilated cavum; Cavum veli interpositi; Lissencephaly with dysgenesis of the corpus callosum; Dysgenesis of the corpus callosum associated the midline dorsal cyst; Holoprosencephaly, alobar type; Schizencephaly associated with Hydranencephaly; Encephaloclastic porencephaly; Severe hydrocephalus; Variant type of Dandy-Walker cyst with dysgenesis of the corpus callosum; Arnold-Chiari malformation. The patients were initially seen OPD primarily for seizures and other complaints such as nystagmus with visual impairment, hypotonia, facial anomalies, Yolk-sac tumor, prematurity, dyspnea and hydrocephalus. Among these, Holoprosencephaly was easiest to diagnose because it was combined with facial anomalies. However the others required evaluation by CT. CT offers very efficient diagnostic modality which is better than a Cranial Echo. It is also safer than the invasive angiography and not as expensive as MRI.
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PMID:[Congenital anomalies of the brain in computed tomography]. 276 27

In a patient with clinical manifestations suggestive of brain malformation, CT showed lissencephaly with absent opercularization. The child had seizures but not a typical EEG of hypsarhythmia. MRI confirmed the diagnosis and showed heterotopic grey matter and abnormal basal ganglia. High grey-white matter contrast and the possibility of imaging the brain in sagittal, coronal and transverse planes make MRI the methode of choice for the evaluation of lissencephaly and other brain malformations.
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PMID:[MRI in the diagnosis of lissencephaly. Apropos of a case]. 307 24

A newborn is reported with diffuse gliomatosis involving the cerebral hemispheres, the brainstem and the cerebellum. The presenting signs were paucity of spontaneous movements except for multifocal clonic seizures, absent response to sensory stimuli and optic atrophy. A CT scan suggested agyria. The child expired on the seventh day. Autopsy disclosed diffuse gliomatosis affecting both cerebral hemispheres, the brainstem and the whole cerebellum, but excluding the spinal cord. Neuronal loss was unusually severe in all the affected areas. The genitals were ambiguous, an association not explained by the cerebral pathology. The karyotype was 46XY (male pseudohermaphroditism). This is probably the first reported instance of gliomatosis cerebri in a newborn.
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PMID:Gliomatosis cerebri in a newborn. 320 77

Migration anomalies are congenital malformations caused by insults to migrating neuroblasts during the third to fifth gestational months. Included in this group are agyria, pachygyria, polymicrogyria, unilateral megalencephaly, schizencephaly, and gray matter heterotopias. Patients who have these conditions present clinically with developmental delay and seizures, and abnormal motor skills are noted in the more severely affected infants. To determine the utility of MR as a method for imaging in these patients, we used MR to evaluate 13 patients who had the full spectrum of migration anomalies. MR was more sensitive than CT in detecting these anomalies because of its better contrast between gray and white matter. We found that MR was particularly more sensitive in detecting schizencephaly, where recognizing the presence of gray matter lining the cleft is critical to distinguishing that disease from porencephaly, and in detecting polymicrogyria, where critical details of cortical architecture are obscured on CT by the overlying bone. Multiplanar capabilities were also found to be essential, since narrow clefts may not be detected when the imaging plane is parallel to the cleft. MR should be the primary imaging method for infants who have seizures or developmental delay.
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PMID:MR of neuronal migration anomalies. 325 18

In a patient with clinical manifestations suggestive of brain malformation, computer-assisted tomography (CT) showed lissencephaly: agyria, pachygyria, absent opercularization, and colpocephaly. The patient did not have seizures or a typical EEG of hypsarrhythmia. By magnetic resonance imaging (MRI), using a long inversion-recovery sequence, it was possible to verify the CT-findings and to demonstrate heterotopic grey matter and missing claustrum. By MRI it was much easier to estimate the altered ratio of grey and white matter. High grey-white matter contrast of inversion-recovery scans and the possibility of imaging the brain in sagittal, coronal and transverse planes make MRI the method of choice for the evaluation of lissencephaly and other brain malformations. In this case it helped to verify lissencephaly as one aspect of an unknown clinical entity of type-I-lissencephaly, defective structure of lymphatic nodes, a polyarthritis-like clinical picture, hypodontia, and flaring of the ribs.
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PMID:Magnetic resonance imaging in lissencephaly. 356 64

Electro-clinical patterns of seizures were studied in 7 infants with Aicardi Syndrome. In all 7 cases, partial seizure preceded the appearance of asymetrical spasms. Partial seizures and spasms were recorded by polygraphing tracings of long duration. There was a constant correlation between the EEG localization of partial seizures and the side of asymetrical spasms. In 6 cases, a cluster of spasms followed the partial discharge whereas in the 7th case, the partial discharge appeared in the middle of the cluster. Therefore, both partial seizure and cluster of spasms seem to be part of the same critical manifestation. The authors have recorded the same king of seizures in other malformative syndromes (lissencephaly, Bourneville disease) and compare them to those recorded in Aicardi Syndrome. In Aicardi Syndrome, this type of seizures might be in relation with the association of a corpus callosum agenesy and paraventricular heterotopies.
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PMID:[Electroclinical characteristics of seizures in the Aicardi syndrome]. 382 49

Changes in EEG and susceptibility to electrically induced seizures were examined in the ferret with lissencephaly produced by exposure to a single injection of methylazoxymethanol acetate (MAM Ac) given to the pregnant jill on gestation day 32. Ten lissencephalic and 11 normal ferrets were chronically implanted with 14 cortical stainless steel electrodes. EEG records were sampled from various stages of the sleep/awake cycle. Six of each group were subjected to electrical stimulation for seizure threshold. Although the number of stimulations and the current intensity required to produce epileptiform afterdischarges (AD) and seizures were not different between the two groups, the lissencephalic ferrets had significantly longer AD and seizures, and a greater number of generalized seizures, indicating an enhanced seizure susceptibility. The EEG of the lissencephalic ferrets was characterized by increased slow wave activity within the low theta band range, extreme spindle activity, focal or multifocal slow and sharp waves, spikes, or spike and slow wave complexes. The differences in the EEG were more pronounced during drowsiness and sleep stages. The brains of all of the treated animals were lissencephalic and hydrocephalic, and weighed significantly less than those of the normals. The cerebral cortex was thin and flattened, with the parieto-occipital region most severely affected. Heterotopic foci were found in the cerebellum as well as in the cerebral cortex. Abnormalities in the configuration of the cerebellar folia were also seen. Comparison between the electrophysiological and neuropathological data suggests that the extent of the extreme spindle activity, and longer AD and seizure duration depended on the degree of cerebellar dysplasia, whereas the EEG focal abnormalities were related to lesions in the cerebral hemispheres.
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PMID:EEG and seizure threshold in normal and lissencephalic ferrets. 646 99

A 4-month-old infant with lissencephaly syndrome who was diagnosed on the basis of clinical symptoms and computed tomography experienced four apnea attacks during three polysomnographies. Apnea attacks were of two types. Type I apnea attacks were thought to be sleep apnea. The cause is unknown. Apnea was followed by tonic seizures due to hypoxia. Type II apnea attacks were thought to be epileptic apneic attacks, because they proceeded from the epileptic discharges in the right anterior temporal region (lead of electrooculogram). The origin of Type II apnea attacks was focused in the limbic system.
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PMID:A case of lissencephaly (agyria) syndrome with apnea--polygraphic study. 648 82


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