Megalencephalic leukoencephalopathy with subcortical cysts: A report of four cases
Amit Batla1, Sanjay Pandey, Ravi Nehru
1Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Abstract:
Megalencephalic leukoencephalopathy with subcortical cysts is an inherited autosomal recessive disorder with characteristic MRI features and a variable but mild clinical course. Frontal and temporal subcortical cysts are the diagnostic hallmark. It usually presents with pyramidal and cerebellar signs. Megalencephaly is usually detected early. Seizures may be present but are usually easily controlled. It has been reported commonly from a certain ethnicity of northern Indian origin, but its presence is global. We encountered four patients and describe the clinical and radiological features of these patients. Seizures though reported to be uncommon were seen in all our patients. Neuropsychiatric features have not been described as presentation so far but one of our patients had moderately severe depression. All the patients were diagnosed by MRI features and they responded well to symptomatic treatment.
Insights
Megalencephalic leukoencephalopathy with subcortical cysts (MLC) is a rare genetic disorder. This study highlights its key MRI findings and presents cases with unexpected seizure prevalence and neuropsychiatric symptoms.
Area of Science:
- Neurology
- Radiology
- Genetics
Background:
- Megalencephalic leukoencephalopathy with subcortical cysts (MLC) is an inherited autosomal recessive disorder.
- Characteristic MRI findings include frontal and temporal subcortical cysts, with megalencephaly often detected early.
Observation:
- This study details four patients with MLC, focusing on clinical and radiological features.
- Seizures, reported as uncommon, were present in all observed patients.
- One patient presented with moderately severe depression, a previously undescribed initial manifestation.
Findings:
- All patients were diagnosed via characteristic MRI features.
- Despite typical presentation, seizures were universally observed in this cohort.
- Neuropsychiatric features, like depression, emerged as a potential presenting symptom.
Implications:
- The findings expand the understanding of MLC's clinical spectrum and diagnostic markers.
- Early diagnosis through MRI enables timely symptomatic management.
- Further research into the prevalence of seizures and neuropsychiatric symptoms in MLC is warranted.
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