Cerebral palsy and associated neurodevelopmental impairments in children with cortical dysgenesis

Abstract

Cortical dysgenesis is included in the spectrum of developmental brain anomalies due to neuronal migration disorder. This paperpresents the cases of two boys with cerebral palsy and associated neurodevelopmental impairments due to cortical dysgenesis. Thefi rst patient is a boy at the age of 5 years who was diagnosed with left-sided hemiparesis. Electroencephalogram showed focal rightsidedcentrotemporal spikes, and magnetic resonance of the brain displayed cerebral cortex malformation consistent with opercularsyndrome of the right hemisphere. The child is included in physiotherapy and, due to articulation impairments, speech andlanguage therapy. Until now, he has not experienced seizures. The other patient has developed left-sided hemiparesis since infancy.He was born in the 33rd week of gestation and had perinatal infection. Serum level of cytomegalovirus (CMV) IgG and polymerasechain reaction in urine and serum were positive, but ganciclovir therapy was not indicated. At the age of 3 years, the boy developedunilateral spastic cerebral palsy. Electroencephalogram showed spikes over the right hemisphere with a tendency to generalize.Magnetic resonance of the brain showed neuronal migration disorder in terms of bilateral pachygyria. The boy is involved in physiotherapy,occupational therapy and speech and language therapy due to delayed speech development. Seizures have not occurredto date. Electroencephalographic discharges are still present. In conclusion, neurodevelopmental outcomes of our patients withcortical dysgenesis are marked with cerebral palsy with associated neurodevelopmental impairments, speech and language disorders,and a risk of developing epilepsy due to abnormal electroencephalogram. We conclude that cortical dysgenesis should betaken in consideration as a possible cause of cerebral palsy. Correct visualization may be obtained by magnetic resonance imagingof the brain.