Megalencephaly-capillary malformation polymicrogyria: A review and complex pediatric case report
Ashlee R Loughan1, Murphy Harrell2, Robert Perna3
1a Department of Neurology , Virginia Commonwealth University , Richmond , Virginia , USA.
Abstract:
Megalencephaly-Capillary Malformation Polymicrogyria (M-CAP) is a rare genetic disorder characterized by a spectrum of anomalies including macrocephaly and neurovascular malformations. Although developmental delays have been identified, research is devoid of neuropsychological data. This case report presents the neuropsychological profile of a 7-year-old, identified with M-CAP. Neuropsychological evaluation was completed subsequent to medical diagnosis. Reports from both parents and teachers included cognitive regression; specifically in the recall of learned material, reading, and information sequencing. Direct testing revealed a WISC-IV GAI at <1st percentile, a diverse range of scores across the battery, and a splinter skill strength of average to above on visual memory tests. Performance included below grade level reading and writing, reduced adaptive functioning, and reported executive dysfunction. Her strong visual memory skills were recommended as a medium to enhance learning. Neurocognitive deficits revealed diverse, multisystem and multifocal impairments. The neuropsychological evaluation also showed significant decline from the previous evaluation and prompted a neurologic consult and corrective surgical procedure.
Insights
This case report details the neuropsychological profile of a 7-year-old with Megalencephaly-Capillary Malformation Polymicrogyria (M-CAP). The study highlights significant cognitive deficits and a decline in functioning, emphasizing the need for tailored interventions.
Area of Science:
- Neuroscience
- Genetics
- Developmental Psychology
Background:
- Megalencephaly-Capillary Malformation Polymicrogyria (M-CAP) is a rare genetic disorder.
- Characterized by macrocephaly and neurovascular anomalies.
- Limited neuropsychological data exists for M-CAP patients.
Observation:
- A 7-year-old diagnosed with M-CAP underwent neuropsychological evaluation.
- Parent and teacher reports indicated cognitive regression in recall, reading, and sequencing.
- Direct testing showed a General Ability Index (GAI) below the 1st percentile.
Findings:
- The patient exhibited a wide range of scores, with average to above-average visual memory skills.
- Performance was below grade level in reading and writing, with reduced adaptive functioning.
- Executive dysfunction was reported, and a significant decline from previous evaluations was noted.
Implications:
- Neurocognitive deficits in M-CAP are diverse, multisystem, and multifocal.
- Strong visual memory skills present a potential avenue for enhanced learning strategies.
- Findings prompted further neurological consultation and surgical intervention.


