A significant portion of patients with neurodevelopmental abnormalitie
s (mental retardation, learning disabilities, and so forth) have no de
finable cause for these problems. Mounting evidence suggests a substan
tial number of these idiopathic conditions have subtle abnormalities o
f brain development (cerebral dysgenesis) as the inherent pathophysiol
ogic event. In this article the authors summarize normal and abnormal
brain development, the diagnostic approach to idiopathic neurodevelopm
ental anomalies, and the new molecular genetic insights into the under
lying causes of brain malformations.