[Multicystic encephalomalacia. Review of 19 cases]

Area of Science:

• Pediatric Neurology
• Neuroimaging
• Developmental Pediatrics

Background:

• Multicystic encephalomalacia (EMQ) is a severe pediatric condition where brain tissue is replaced by fluid-filled cavities.
• Understanding the etiology, diagnostic methods, and clinical progression of EMQ is essential for managing affected children.

Purpose of the Study:

• To retrospectively analyze the causes, diagnostic approaches, and clinical and radiological outcomes of multicystic encephalomalacia (EMQ) in a cohort of pediatric patients.
• To evaluate the effectiveness of different neuroimaging modalities in the early diagnosis of EMQ.

Main Methods:

• Retrospective analysis of 19 children diagnosed with multicystic encephalomalacia (EMQ).
• Review of etiological factors, diagnostic imaging (cerebral ultrasonography, CT, MRI), and clinical and radiological evolution.
• Assessment of patient outcomes, including mortality, neurological deficits, and long-term consequences.

Main Results:

• Common etiologies included twin pregnancy (12 cases), perinatal hypoxia (4 cases), and perinatal infection (1 case).
• Cerebral ultrasonography proved highly effective for early and reliable EMQ diagnosis.
• The clinical outcome was predominantly unfavorable, with 73% of patients experiencing severe consequences such as intellectual disability, microcephaly, spastic tetraplegia, and epilepsy. Two children died, and the remaining showed spastic hemiplegia.

Conclusions:

• Multicystic encephalomalacia (EMQ) is a rare pediatric disease associated with a very poor prognosis.
• Early and accurate diagnosis is critical for managing EMQ.
• Cerebral ultrasonography is the preferred imaging modality for the early detection of EMQ in children.