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Unilateral polymicrogyria: a common cause of hemiplegia of prenatal origin

I Pascual-Castroviejo1, S I Pascual-Pascual, J Viaño

  • 1Pediatric Neurology Service, University Hospital La Paz, Paseo de la Castellana 261 28046, Madrid, Spain. pascas@inves.es

Brain & Development
|May 30, 2001
PubMed

Insights

Unilateral polymicrogyria, a brain malformation, is linked to hemiparesis and seizures in children. Advanced 3D MRI is crucial for accurate diagnosis and assessing severity.

Area of Science:

  • Neurology
  • Developmental Neuroscience
  • Medical Imaging

Background:

  • Polymicrogyria is a congenital brain malformation characterized by an excessive number of small cerebral cortical folds.
  • Clinical manifestations can vary widely, often including neurological deficits such as motor impairments and epilepsy.

Purpose of the Study:

  • To describe the clinical and neuroimaging findings in a cohort of pediatric patients with unilateral polymicrogyria.
  • To evaluate the diagnostic utility of conventional versus three-dimensional magnetic resonance imaging (3D MRI) in identifying polymicrogyria.

Main Methods:

  • Retrospective case series of 13 pediatric patients (3-14 years) diagnosed with unilateral polymicrogyria.
  • Clinical data including neurological examination, seizure history, and pregnancy complications were collected.
  • Conventional MRI and 3D MRI were utilized for neuroimaging analysis.

Main Results:

  • All patients presented with unilateral polymicrogyria, predominantly affecting the right hemisphere (9/13).
  • Hemiparesis was the primary clinical finding in all cases.
  • Seizures occurred in 10 patients, with 7 achieving complete control.
  • Conventional MRI underestimated or missed polymicrogyria in 4 cases, diagnosing cortical dysplasia instead.
  • 3D MRI provided detailed visualization of polymicrogyria, its extent, and severity.

Conclusions:

  • Unilateral polymicrogyria presents with consistent hemiparesis and variable seizure activity in pediatric patients.
  • 3D MRI is superior to conventional MRI for the accurate detection and characterization of polymicrogyria.
  • Advanced imaging techniques are essential for precise diagnosis and understanding the anatomical abnormalities in polymicrogyria.

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