Functional MRI in a 6-year-old boy with unilateral cortical malformation: Concordant representation of both hands in the unaffected hemisphere

Functional magnetic resonance imaging (fMRI) was performed in a 6-year-old boy with a complex malformation of the right hemisphere who suffered from p harmaco-refractory epilepsy. Clinical examination revealed left-sided hemip aresis and marked mirror movements of the opposite hand both during paretic and non-paretic hand movements. Functional MRI of repetitive unimanual gra sping demonstrated that the two hands share a common cortical representatio n located in the central motor region of the unaffected left hemisphere. Th e affected right hemisphere did not show any activation during either task. This case study demonstrates the feasibility and usefulness of motor fMRI in young children before they undergo epilepsy surgery.