Presentation
The most common clinical presentation is intractable seizures. Heterotopia present as nodular foci of grey matter intensity on all sequences. They do not enhance. Heterotopia Images of a typical subependymal heterotopia. [radiologyassistant.nl]
Cortical dysplasia; other clinical presentations Dysplasia involving extratemporal regions demonstrates earlier age at presentation, more severe epilepsy, higher incidence of mental retardation and developmental delay. 21. [slideshare.net]
Although focal cortical dysplasia is a congenital malformation and present at birth, the patient may not develop epilepsy until childhood, adolescence, or adulthood. [rscdiagnosticservices.com]
Patients usually present with intractable seizures. [ajnr.org]
The clinical presentation is related to the association with either schizencephaly (presenting with seizures) or hypothalamic and pituitary hypoplasia (presenting with pituitary insufficiency). [mrineonatalbrain.com]
Entire Body System
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Disability
genetic, non-syndromic cerebral malformation due to abnormal neuronal migration disease characterized by the association of cortical dysplasia and pontocerebellar hypoplasia, manifesting with global developmental delay, mild to severe intellectual disability [malacards.org]
In addition, we report 1 individual with macrocephaly and intellectual disability without seizures. [ng.neurology.org]
Abnormal cortical development is increasingly recognized as a cause of developmental disabilities and epilepsy. [karger.com]
Present with – Epilepsy / learning disability. MRI: Lobar / gyral hypoplasia, atrophy of underlying white matter blurring of gray- white border. Increased T2 & decreased T1 signal intensity. 15. [slideshare.net]
Brain 129: 352– 365 Google Scholar Shepherd CW, Stephenson JBP (1992) Seizures and intellectual disability associated with tuberous sclerosis complex in the west of Scotland. [link.springer.com]
Respiratoric
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Respiratory Distress
distress, and dysphagia, early-onset, mild variant 614399 612453 Autosomal recessive METTL23 17q25.1 Mental retardation, autosomal recessive 44 615942 615262 Autosomal recessive MFN2 1p36.22 Charcot-Marie-Tooth disease, axonal, type 2A2A 609260 608507 [mnglabs.com]
Psychiatrical
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Aggressive Behavior
Seizures from the cingulate gyrus can involve screaming, aggressive behavior, and feelings of intense fear. The heart and breathing rate may rise, and sweating and pallor can also occur. [childneurologyfoundation.org]
Neurologic
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Opisthotonus
Early hypotonia, later spastic quadriplegia and opisthotonus. 8. Subcortical band heterotopia-Double cortex Sub-cortical, symmetric, circumferential bands of gray matter, separated from cortex by thin band of white matter. [slideshare.net]
Workup
This requires extensive workup with detailed brain imaging and EEGs. A neurosurgeon will then surgically remove the area of the brain that is causing the seizures. This is called epilepsy surgery. [childneurologyfoundation.org]
Treatment
Surgical treatment for localization related infantile spasms. Clinical Neurology and Neurosurgery. Apr 2011. 113 (3):213-7. Olson HE, et al. Rufinamide for the treatment of epileptic spasms. Epilepsy and Behavior. Feb 2011. 20(2):344-8. [rarediseases.org]
Treatments may lessen or alleviate seizures and improve the quality of life for HME patients. [hemifoundation.homestead.com]
What are the Treatments? The treatment is based on controlling the seizures. Focal seizures with identified focal cortical dysplasia can be very difficult to control with antiepileptic medications. [rscdiagnosticservices.com]
Your doctor will then talk with you about a few other treatment options. What other treatment options are there? Epilepsy surgery, vagus nerve stimulator (VNS), and ketogenic diet are some treatment options available if medications have failed. [childneurologyfoundation.org]
Prognosis
[ edit ] The prognosis for children with NMDs varies depending on the specific disorder and the degree of brain abnormality and subsequent neurological signs and symptoms. [2] References [ edit ] Sarnat, Harvey (1992). [en.wikipedia.org]
The careful assessment of patients with these abnormalities is important in order to provide an accurate prognosis and genetic counselling. [jnnp.bmj.com]
On the other hand bottom of the sulcus appears as a highly epileptogenic lesion with an excellent prognosis for seizure control following focal resection. [neurocirugia-princesa.net]
PMID: 14617703 Free PMC Article Prognosis Arya R, Tenney JR, Horn PS, Greiner HM, Holland KD, Leach JL, Gelfand MJ, Rozhkov L, Fujiwara H, Rose DF, Franz DN, Mangano FT J Neurosurg Pediatr 2015 Jan;15(1):26-33. doi: 10.3171/2014.10.PEDS14107. [ncbi.nlm.nih.gov]
PROGNOSIS What is the outcome with treatment? About 60 to 70% of children will stop having seizures after treatment with one AED. Response to therapy depends a great deal on the seizure type and the cause for the epilepsy. [childneurologyfoundation.org]
Etiology
HPV16 E6 expression during fetal brain development is a novel etiology for FCDIIB, but the mechanism and relation of the HPV16 to the cause of epilepsy associated with focal cortical dysplasia is unexplained. [pediatricneurologybriefs.com]
ETIOLOGY Many authors consider this abnormalities that produce FCD can be attributed to a combination of environmental and genetic factors. [neurocirugia-princesa.net]
The underlying etiology of infantile spasms (West syndrome) from the United Kingdom Infantile Spasms Study (UKISS) on contemporary causes and their classification. Epilepsia. Oct 2010. 51(10):2168-74. Peltzer B, et al. [rarediseases.org]
Cortical dysplasia is the most common substrate in pediatric and the second or third most frequent etiology in adult epilepsy surgery patients 18. [slideshare.net]
MCD encompass a wide spectrum of focal and diffuse disorders with various underlying genetic etiologies and clinical manifestations. [hemifoundation.homestead.com]
Epidemiology
Relevant External Links for KIF5C Genetic Association Database (GAD) KIF5C Human Genome Epidemiology (HuGE) Navigator KIF5C Atlas of Genetics and Cytogenetics in Oncology and Haematology: KIF5C No data available for Genatlas for KIF5C Gene Personalized [genecards.org]
Neurology 76: 1548–1554 Google Scholar Kaderali Z, Lamberti-Pasculli M, Rutka JT (2009) The changing epidemiology of paediatric brain tumours: a review from the Hospital for Sick Children. [link.springer.com]
Epidemiology Neural tube defects (NTDs) are among the most common congenital abnormalities but prevalence varies between countries and races. [jnnp.bmj.com]
Tinkle BT, Schorry EK, Franz DN, Crone KR, Saal HM: Epidemiology of hemimegalencephaly: a case series and review. Am J Med Genet A 139:204-211 (2005). [karger.com]
Pathophysiology
Pathophysiology. Acid-base balance: part II. Pathophysiology. Crit Care Resusc. 2001 Sep;3(3):188-201. PubMed Health hazards due to the inhalation of amorphous silica. Health hazards due to the inhalation of amorphous silica. [ncbi.nlm.nih.gov]
Pathophysiological mechanisms of focal cortical dysplasia: a critical review of human tissue studies and animal models. Epilepsia 48(Suppl. 2), 21–32. [frontiersin.org]
Despite this limitation, it was possible to address several aspects that relate to pathophysiological mechanisms in tubers. [journals.plos.org]
Prevention
Rapamycin prevents epilepsy in a mouse model of tuberous sclerosis complex. Ann. Neurol. 63, 444–453 (2008). Download references Acknowledgements We thank E.J. Kim, J. Kim and S. [nature.com]
PREVENTION Seizures can be prevented by regularly taking the prescribed medications. In fact, not taking medications is the most common cause for breakthrough seizures. During times of illness or stress, seizures can occur. [childneurologyfoundation.org]
Fox JW, Lamperti ED, Ekşioğlu YZ, Hong SE, Feng Y, et al: Mutations in filamin 1 prevent migration of cerebral cortical neurons in human periventricular heterotopia. Neuron 21:1315-1325 (1998). [karger.com]