Cortical dysgenesis comprises a heterogenous group of genetic or acquired d
isturbances of cortical development which, due to progress in modern neuroi
maging techniques, are increasingly recognized in association with a variet
y of clinical disorders. The spectrum of clinical manifestations, depending
on type and extent of the alterations, includes severe mental retardation
and epilepsy as well as neuropsychological deficits and psychiatric disorde
rs. Up to now,the nomenclature of cortical malformations has been difficult
and ambiguous. Recently, the understanding and terminology of these disord
ers has been facilitated by the proposal of a new classification scheme bas
ed on pathophysiological as well as pathogenetic mechanisms. This proposal
has been elaborated by a group of experts and is not yet well-known in the
German literature. Magnetic resonance imaging (MRI) allows diagnosis and cl
assification in many cases of cortical dysgenesis during lifetime, thereby
helping to identify prognostic and therapeutic options. Early diagnosis of
cortical malformations is of particular importance in patients with drug-re
sistant epilepsy,as they can either be cured or benefit from epilepsy surge
ry. This review gives examples of the most relevant cortical malformations
using the new classification scheme and summarizes their clinical as well a
s MRI characteristics. Besides routine MRI applications, some experimental
techniques are discussed which may help to identify even subtle alterations
.