Question Title: Abnormal MRI

Forum: Neurology Forum
Topic: Speech

Posted by CCF Neuro Md *!* on December 02, 1997 at 20:16:35:

In Reply to: Abnormal MRI posted by Gay Mockerman on December 02, 1997 at 12:25:55:

: I have a 22month old foster son who we will be adopting soon. We have had him since he was 4 months. He was neglected when he was an infant, mother has drug and alcohol problems. He was very difficult infant, crying, easily overstimulated, severe reflux and delayed development. He has since come a long way and is on target developmentally except for speech. The concern at this time is a MRI that showed " a slight abnormality in the white matter" The MRI was done because his head circ. didn't grow with the rest of him, an abnormal reflex in his lle, and I had noticed him falling freq. He also had a birthmark over his spine that the Dr. was concerned about. He also has been having loose frothy type stools almost every day. The Dr. said that at this time they are not sure what the MRI indicates, ? metabolic disorder. Dr. said just to watch his development closely at this time and if he seems to be falling off they will refer him to neurologist. He doesn't seem to be tripping as much but he is very small for his age. I'm wondering if it is reasonable to wait for referral. Could an abnormality in white matter be damage from drugs, learning disability or ADD?

Dear Gay,
The report of “ slight abnormality in the white matter “ is a difficult one to quantify as the type of abnormality, its location etc. are not clarified ( and may not have been in the report ). This is particularly difficult in a child who has a history of fetal alcohol syndrome, maternal drug abuse and some developmental problems.
In general abnormalities in white matter, especially if metabolic in nature are categorized under the heading of Leukodystrophies, this is a very large group of inherited disorders which presents usually in the first year of life with failure to reach normal milestones and striking abnormalities on MRI.
The fact that your foster son has spent much of his time catching up from his previous baseline rather than regressing would suggest that this is less likely.
As regards the second part of your question, abnormalities in brain white matter tracts, especially one called the corpus callosum have been described in children of mothers with alcohol abuse during pregnancy.
The white matter changes are likely to be a cause of rather than a consequence of ADD or learning disability.
As regards waiting for a referral , now that the question has been raised I suspect that you are going to worry until you get a definitive answer, I would suggest that if you are not rapidly reassured by developments you should arrange an appointment with a pediatric neurologist to achieve some peace of mind, (take the scans with you !)
The Pediatric Neurology Dept. in the Cleveland Clinic sees many children with similar problems every year , if you wish to make an appointment the number id (216) 444 5559.

This information is provided for general medical education purposes only.
Please consult your physician for diagnostic and treatment options of your specific medical condition.

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