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IMAGES IN NEUROLOGY
Year : 2022  |  Volume : 25  |  Issue : 3  |  Page : 485-486
 

An unusual EEG pattern associated with a complex malformation of cortical development


1 Department of Pediatric Neurology, Amrita Institute of Medical Sciences, Cochin, Kerala, India
2 Department of Neurology, Amrita Institute of Medical Sciences, Cochin, Kerala, India
3 Amrita Advanced Centre for Epilepsy, Amrita Institute of Medical Sciences, Cochin, Kerala, India

Date of Submission12-Dec-2021
Date of Acceptance13-Jan-2022
Date of Web Publication25-Jun-2022

Correspondence Address:
Kollencheri Puthenveettil Vinayan
Department of Pediatric Neurology, Amrita Institute of Medical Sciences, Cochin - 682 041, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aian.aian_1066_21

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How to cite this article:
Jyostna AS, Vinayan KP, Anand V, Shridharani A, Ravindran S. An unusual EEG pattern associated with a complex malformation of cortical development. Ann Indian Acad Neurol 2022;25:485-6

How to cite this URL:
Jyostna AS, Vinayan KP, Anand V, Shridharani A, Ravindran S. An unusual EEG pattern associated with a complex malformation of cortical development. Ann Indian Acad Neurol [serial online] 2022 [cited 2022 Aug 14];25:485-6. Available from: https://www.annalsofian.org/text.asp?2022/25/3/485/345407




A 5-month-old infant with macrocephaly and dysmorphism presented with seizures. Magnetic resonance imaging of the brain showed fused lateral ventricles and the absence of mid-line structures (inter-hemispheric fissure, septum pellucidum, and corpus callosum). A large dorsal cyst was seen, pushing the thin strip of the remaining fused cerebral cortex anteriorly. Imaging was suggestive of alobar holoprosencephaly [Figure 1]a. The electroencephalogram (EEG) showed a decreasing gradient of electrical potentials from the frontal electrode to the occipital electrode, with an almost isoelectric line over the most posterior leads [Figure 1]b. The electrical isolation of the posterior electrodes from the thin strip of the cerebral cortex by the huge dorsal cyst might be considered as the most plausible hypothesis for this unusual EEG pattern.[1],[2]
Figure 1: (a): (Left) Sagittal T2 – A strip of cerebral parenchymal tissue over the frontal region (small arrow). A dorsal cyst occupies the rest of the supratentorial compartment (big arrow). (a): (Right) Axial T2 – Single ventricle (small arrow) and the absence of mid-line structures (inter-hemispheric fissure, septum pellucidum, and corpus callosum). The cerebral cortex is fused and pushed anteriorly by the large dorsal cyst (big arrow). (b): EEG in the bipolar longitudinal double banana (left) and referential common average (right) montages. Note the decreasing gradient of potentials from the frontal to occipital electrode chains, with an almost isoelectric recording in the most posterior leads, especially on the bipolar montage (arrows)

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the legal guardian has given his consent for images and other clinical information to be reported in the journal. The guardian understands that names and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.



 
   References Top

1.
Yang MT, Lee WT, Peng SS, Lin HC, Tseng CL, Liang JS, et al. The roles of electroencephalography and neuroimaging in children with holoprosencephaly. Epileptic Disord 2004;6:173-80.  Back to cited text no. 1
    
2.
Hahn JS, Delgado MR, Clegg NJ, Sparagana SP, Gerace KL, Barkovich AJ, et al. Electroencephalography in holoprosencephaly: Findings in children without epilepsy. Clin Neurophysiol 2003;114:1908-17.  Back to cited text no. 2
    


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