Cystic leukoencephalopathy without megalencephaly
Seizures for two years. In use of oxcarbazepine. No microcephaly or macrocephaly physical examination.
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High signal intensity in the supratentorial white matter, in the corona radiata, semioval centers and mainly in subcortical temporal lobes, accompanied by symmetrical cysts in the temporal poles.
The findings of this rare condition are bilateral temporal lobe cysts combined with a specific pattern of multifocal white matter lesions and normocephaly.
The differential diagnosis of cystic lesions of the temporal lobe are:
- with microcephaly: congenital CMV infection
- normocephaly: cystic leukoencephalopathy without megalencephaly, congenital muscular dystrophy merosin negative, Aicardi-Goutieres syndrome
- with megalencephaly: megalencephalic leukoencephalopathy with subcortical cysts (also known as Van der Knaap disease).
other differential diagnoses to include:
- leukoencephalopathy with vanishing white matter (Vanishing white matter disease)
- childhood ataxia with central nervous system hypomyelination