10 m male with microcephaly, seizures , spastic paraplegia, optic atrophy on the left , pneumonia one month back

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May help , pattern is from - caudal to rostral, central to peripheral, dorsal to ventral and sensory then motor
Thank you Sir
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Cerebral palsy
Krabee disease
Near total white matter hyperintensities with patchy sparing of corpus callosum , cerebral atrophy , patchy subtle hyperintensities in the pons associated with microcephaly , spatsic paraplegia , seizures , optic atrophy in an infant male should raise the possibility of spastic paraplegia related syndromes such as pelizaeus merzbacher disease , pelizaeus merzbacher like disease , congenital white matter hypoplasia of unknown cause. DD can be Salla disease , similar imaging findings , but most likely associated with coarse facial features. Krabbe as mentioned above by the docs , but hypertonia is expected in the infantile form , ( also seen in mma , IVA ) along with dentate nucleus and brainstem tracts abnormalities , with majority showing few perivascular deposits of globoid cells ( tigroid pattern ) Other DDS to be considered are congenital Infections , should have associated focal lesions like calcifications or grey matter malformations etc along with white matter abnormality..GM gangliosidosis ( macrocephaly , basal ganglia patchy hyperintensities, cherry red spot ) Cockayne ( usually associated with calcifications, cerebellar and brainstem. Atrophy )
Sir, seizures in PM disease are very rarely seen as per literare... Calcification is difficult to pick in these images; Shud we go for CT
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Prominent extraxial CSF spaces with prominent ventricles suggestive of atrophy.. Myilination arrest as per your chart... Paucity of periventricular white matter which can explain spastic diplegia... Optic atrophy may be due to chorioretinitis... Diagnosis. Congenital CMV White matter disease (leukodystrophy)
Leukodystrophy probably Globoid cell (Krabbe's disease)
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As per chart provided by you sir, I think complete white matter looks hyperintense on T2 with slight myeilination in corpus callosum..... Probably hypomyielination or myielination arrest.... Please discuss MRI findings in detail for us.... It wud be a good learnjng experience for me... Thank you
Delayed myelination (not myelination arrest)
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Centrum semiovale is hyperintense which shud be myielinated by now... Internal capsule also seems to be hypointenseb which means it's myilinated Corpus callosum is also partially myelinated.... As per chart provided by you Sir... It seems that myilination arrest is present
Sir, how to assess myilination in young children less than 18 months Any trick to assess and remember sequence of myeilination
Is the brain myelinated for 10 m ?
It is a case for paediatrics.
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