Childhood Frontal Lobe Epilepsies: Etiology, Classification, and EEG Findings
kiran Sanalli, Sweta Mukherjee, K Uday Bhanu, VISHAL SONDHI, Sachendra Badal
Objective: To describe children with Mirror Movements (MMs) and insights from functional MRI. Background: MMs are involuntary movements of one side of the body that mirror the intentional movement of the contralateral homologous body part. These movements may be present as a syndromic association as well as hemiplegic cerebral palsy. Non syndromic and nonstructural cases may be genetic such as DCC and RAD51 mutations.
Method & Results: Case 1: A 9 year developmentally normal girl presented with history of MMs in both hands since 2 years of age. Neurological examination was essentially normal .MRI Brain was essentially normal and Functional MRI showed BOLD activation of bilateral motor cortex in the hand-knob region, on finger tapping tasks of the both hands. Case 2: A 10 year boy presented with abnormal eye movements and history of funny hand movements. There was global developmental delay with cerebellar signs. IQ testing revealed moderate intellectual disability. MRI Brain showed molar tooth sign s/o Joubert syndrome. Child was noncooperative for Functional MRI.
Bimanual synkinesis on asking to perform hand tasks including writing was demonstrated in both children. The course in both has been static without involvement of lower limbs. Both children did not show any worsening on mean follow up of 19 mths. Conclusion: Mirror movements is a soft neurological sign encountered rarely in clinical practice and defined as involuntary, synkinetic mirror reversals of an intended movement of opposite side. Management of such children require special accommodations akin dyslexia and hence need for sensitizing the environment.
Keywords: Congenital mirror movements, functional MRI, molar tooth sign, Joubert syndrome.
kiran Sanalli
ARMED fORCES mEDICAL cOLLEGE
India
Sweta Mukherjee
AFMC
India
K Uday Bhanu
AFMC
India
VISHAL SONDHI
AFMC
India
Sachendra Badal
AFMC
India
Objective: To describe children with Mirror Movements (MMs) and insights from functional MRI. Background: MMs are involuntary movements of one side of the body that mirror the intentional movement of the contralateral homologous body part. These movements may be present as a syndromic association as well as hemiplegic cerebral palsy. Non syndromic and nonstructural cases may be genetic such as DCC and RAD51 mutations.
Method & Results: Case 1: A 9 year developmentally normal girl presented with history of MMs in both hands since 2 years of age. Neurological examination was essentially normal .MRI Brain was essentially normal and Functional MRI showed BOLD activation of bilateral motor cortex in the hand-knob region, on finger tapping tasks of the both hands. Case 2: A 10 year boy presented with abnormal eye movements and history of funny hand movements. There was global developmental delay with cerebellar signs. IQ testing revealed moderate intellectual disability. MRI Brain showed molar tooth sign s/o Joubert syndrome. Child was noncooperative for Functional MRI.
Bimanual synkinesis on asking to perform hand tasks including writing was demonstrated in both children. The course in both has been static without involvement of lower limbs. Both children did not show any worsening on mean follow up of 19 mths. Conclusion: Mirror movements is a soft neurological sign encountered rarely in clinical practice and defined as involuntary, synkinetic mirror reversals of an intended movement of opposite side. Management of such children require special accommodations akin dyslexia and hence need for sensitizing the environment.
Keywords: Congenital mirror movements, functional MRI, molar tooth sign, Joubert syndrome.
kiran Sanalli
ARMED fORCES mEDICAL cOLLEGE
India
Sweta Mukherjee
AFMC
India
K Uday Bhanu
AFMC
India
VISHAL SONDHI
AFMC
India
Sachendra Badal
AFMC
India
