Magnetic resonance imaging in lissencephaly

In a patient with clinical manifestations suggestive of brain malformation, computer-assisted tomography (CT) showed lissencephaly: agyria, pachygyria, absent opercularization, and colpocephaly. The patient did not have seizures or a typical EEG of hypsarrhythmia. By magnetic resonance imaging (MRI), using a long inversion-recovery sequence, it was possible to verify the CT-findings and to demonstrate heterotopic grey matter and missing claustrum. By MRI it was much easier to estimate the altered ratio of grey and white matter. High grey-white matter contrast of inversion-recovery scans and the possibility of imaging the brain in sagittal, coronal and transverse planes make MRI the method of choice for the evaluation of lissencephaly and other brain malformations. In this case it helped to verify lissencephaly as one aspect of an unknown clinical entity of type-I-lissencephaly, defective structure of lymphatic nodes, a polyarthritis-like clinical picture, hypodontia, and flaring of the ribs.