SPECT AND MRI FINDINGS IN A CASE OF EXTENSIVE NEURONAL MIGRATION DISORDER

We report a 20-year-old male with epilepsy, mild mental retardation, g rowth asymmetry, and MRI and SPECT features of unilateral subcortical ectopic cortex. The neurological examination showed mild growth asymme try, hemiparesis and hemihypoesthesia and pyramidal signs on the left side. EEG showed focal abnormality in the right frontotemporal region. MRI revealed pachygyria and severe heterotopia associated with some a bnormalities of ventricles and cerebellum on the right. Cortical respo nses were absent on stimulation of the left median and tibial nerves. Central motor conduction time from cortex to left upper extremity was prolonged in magnetic stimulation test. SPECT using 99 mTc-HMPAO revea led increased perfusion of the right subcortical region as compared wi th those of overlying cortical mantle and opposite hemisphere. To our knowledge, there has been no report documenting such a large and exten sive subcortical ectopic cortex which appears as a mass distorting and shifting the middle structure in an adult. such as in our case. (C) 1 997 Elsevier Science B.V.