Question Title: Focal cortical dysplasia

Forum: Neurology Forum
Topic: Behavioral Disorders

My son is four years and nine-month. He is slow in developing ( walking, talking and ect) but he has a fantastic memory. He is judged to have a chronological age of 38 months when he is 4 year 5 month.

I had 3 children and his boy is second. Both of my other sons are normal and consider intelligent. I had never take any drugs at all (other than pain killer during fever). During pregancy, I do not take liquor nor smoke. I had a very healthy and unevenful pregnancy. He is the only son that is delivered by ' meville Barnes Forceps delivery'.

He had undergoes an MRI examination and below is the report. As a medical-idiot mother, I'm very helpless in understanding what is he sufferring and whether it is incurable. Please interprate the report. Thank you.

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MRI EXAMINATION REPORT:

Clinical History : Big head. Delay development. CT showed megalencephaly.

Imaging Protocol:

SE T1 sagittal 5/1.5; SE T1 axial 5/1.5; FSE PD/T2 axial 5/1.5; FSE T2 coronal 5/1.5

Imaging Findings:

Thickened cortex with relative paucity of underlying white matter was noted over the temporo-parietal regions bilaterally. Suspicious hyperintensity was noted in the posterior white matter bilaterally; ?gliosis.

Otherwise, no abnomal signal intensity lesion or mass lesion was noted in the brain. No obvious cleft to suggest the presence of schizencephaly was noted. The corpus callosum was well formed. No midline shift was detected. The lateral ventricles were mildly prominent. Prominence of the nasopharyngeal soft tissues was noted which probably represents enlarged adenoids. Signal intensities were noted within the right mastoid and right maxillary sinus, ?inflammatory changes.

Impression:

Thickened cortex with relative paucity of underlying white matter over both temporo-parietal regions. Features could represent some form of bilateral focal cortical dysplasia.

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Please help me. Thank you.
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Dear Angelina,

The MRI you describe is consistent with cortical dysplasia. This is an
abnormality in development where the normal migration of neurons is
altered for some reason. The reasons for this abnormal migration are not clear
and are likely due to a number of different factors. There is ongoing research
in this area.

Children with cortical dysplasias are commonly 'slow' and experience
a delayed development, as you have seen in your child. Seizures can occur
with this condition, and you should keep this in mind as your child develops.

There is no specific therapy for cortical dysplasias beyond special schooling
and a loving family. You must remember that you are not at fault for your
child's condition.

You should have your child evaluated by a good neurologist to confirm the diagnosis.
He or she will then be able to direct you to the appropriate persons who can
help you manage your child as he grows and develops.

Good luck.

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