Learning objectives
-Review the major phases of cerebral cortical development
-Identify the phase of cerebral cortical development in which an abnormality occurred for a given malformations of cortical development (MCD) : classification of MCD.
-Identify the distinguishing characteristics of each of the major MCDs on MRI
-Identify the clinical features of the major MCDs.
Background
Malformations of cortical development (MCDs) are macroscopic or microscopic abnormalities of the cerebral cortex that arise as a consequence of an interruption to the normal steps of formation of the cortical plate.MCD are increasinglyrecognized as important causesof several disorders, particularly in childhood.Patients with MCD present with a wide spectrum of clinical manifestations ranging from asymptomatic cases to those with epilepsy,especially refractory epilepsy, developmental delay and other neurological disorders.
Findings and procedure details
I. Major phases of cerebral cortical development:
The human cortex develops its basic structure during the first two trimesters of pregnancy as a series of overlapping steps:
Neural proliferation:
-Between the second and fourth months of gestation.
-Anomalies of neuronal proliferation may result in conditions characterized by too many, too few, or abnormal neurons.
Neuronal migration:
-Between the third and fifth months of gestation.
-Disorders of neuronal migration are due to undermigration, overmigration, or ectopic migration of the neurons.
Postmigrational cortical development:
-Starts at 22...
Conclusion
MCDs are a fascinating, wide-ranging group of disorders, which are common causes of developmental delay and epilepsy. MR imaging allows the detection and classification of cortical malformations.
Personal information and conflict of interest
C. Kerkeni; Monastir/TN - nothing to disclose S. Chemkhi; Mahdia/TN - nothing to disclose K. Hmida; Mahdia/TN - nothing to disclose A. Hkaiem; Mahdia/TN - nothing to disclose M. A. Ayed; Mahdia/TN - nothing to disclose S. Jerbi; Mahdia/TN - nothing to disclose S. Younes; Mahdia/TN - nothing to disclose
References
1-Barkovich, A. James, William B. Dobyns, and Renzo Guerrini. "Malformations of cortical development and epilepsy."Cold Spring Harbor perspectives in medicine5.5 (2015): a022392.
2-Lee, Jeehun. "Malformations of cortical development: genetic mechanisms and diagnostic approach."Korean journal of pediatrics60.1 (2017): 1.
3-Blümcke I, Vinters HV, Armstrong D, Aronica E, Thom M, Spreafico R. Malformations of cortical development and epilepsies: neuropathological findings with emphasis on focal cortical dysplasia. Epileptic Disord 2009; 11:181-93.
4- Wagner J, Weber B, Urbach H, Elger CE, Huppertz HJ. Morphometric MRI analysis improves detection of...