Intrapartum Complications Associated With Malformations of Cortical Development

Maria Augusta Montenegro, MD, PhD; Fernando Cendes, MD, PhD; Helena Saito, MD; Jéssica G. Serra, MD; Camila F. Lopes, MD; Ana Maria S. Piovesana, MD, PhD; Helaine Milanez, MD, PhD; Marilisa M. Guerreiro, MD, PhD

Disclosures

J Child Neurol. 2005;20(8):675-678.

Results

Seventy patients (33 girls) with ages ranging from 2 months to 18 years (mean 6.5 years) were evaluated. Three patients had subcortical laminar heterotopia (double-cortex syndrome), 5 had hemimegalencephaly, 10 had polymicrogyria, 12 had lissencephaly/agyria-pachygyria, and 40 had schizencephaly (Figure 1).

(Enlarge Image)

Malformations of cortical development. Coronal T1-weighted inversion recovery images showing (A) bilateral perisylvian polymicrogyria; (B) bilateral schizencephaly; (C) subcortical laminar heterotopia (double cortex); and (D) lissencephaly/agyria-pachygyria.

Table 1 shows the characteristics of the patients. Intrapartum complications were reported by 22 (31.5%) patients, reduced fetal movement by 8 (11%) patients, and 7 (10%) patients were previously diagnosed as being asphyxiated at birth (see Table 1 ). Only two (4%) patients in the disease control group presented intrapartum complications (P < .001).

Diseases that might be associated with birth complications were hypertension (n = 3), urinary tract infection (n = 2), alcohol or drug addiction (n = 2), diabetes (n = 1), and cardiac disease (n = 1).

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Cite this: Intrapartum Complications Associated With Malformations of Cortical Development - Medscape - Aug 01, 2005.

Characteristics of the Patients
ID	Age	Type of MCD	Neurologic Examination	↓ Fetal Movement	Other Pregnancy Complication	Intrapartum Complication	Diagnosed as Asphyxiated at Birth
1	1 yr	L/A-p	Hypotonia + cognitive deficit	No	No	No	No
2	12 yr	L/A-p	Tetraparesis + cognitive deficit	No	No	No	No
3	5 yr	L/A-p	Hypotonia + cognitive deficit	Yes	UTI	Yes	No
4	5 yr	L/A-p	Hypotonia + cognitive deficit	Yes	No	Yes	No
5	4 yr	L/A-p	Tetraparesis + cognitive deficit	No	No	No	No
6	1 yr	L/A-p	Hypotonia + cognitive deficit	No	No	Yes	No
7	9 yr	L/A-p	Cognitive deficit	Yes	No	No	No
8	12 yr	L/A-p	Cognitive deficit	No	No	Yes	No
9	3 yr	L/A-p	Tetraparesis + cognitive deficit	No	Alcohol abuse	No	No
10	1 yr	L/A-p	Cognitive deficit	Yes	No	No	No
11	6 mo	L/A-p	Hypotonia + cognitive deficit	No	No	No	No
12	8 yr	L/A-p	Hypotonia + cognitive deficit	No	No	No	No
13	18 yr	SLH	Cognitive deficit	Yes	No	Yes	Yes
14	11 yr	SLH	Cognitive deficit	No	Cardiac disease	No	No
15	17 yr	SLH	Cognitive deficit	No	No	No	No
16	2 yr	HMG	Hemiparesis	No	No	Yes	No
17	5 mo	HMG	Hemiparesis	No	No	No	No
18	11 yr	HMG	Hemiparesis	No	No	No	No
19	5 yr	HMG	Hemiparesis	No	No	Yes	No
20	7 mo	HMG	Hemiparesis	No	No	No	No
21	12 yr	PMG	Tetraparesis + mental retardation	Yes	Hypertension + diabetes	Yes	No
22	11 yr	PMG	Hemiparesis	No	No	No	No
23	3 mo	PMG	Hemiparesis	Yes	No	No	No
24	1 yr	PMG	Hemiparesis	No	No	No	No
25	3 yr	PMG	Hemiparesis	No	No	Yes	Yes
26	6 yr	PMG	Hemiparesis	No	No	No	No
27	6 yr	PMG	Hemiparesis	No	Alcohol and drug abuse	No	No
28	8 yr	PMG	Tetraparesis + pseudobulbar signs	No	No	No	No
29	4 yr	PMG	Tetraparesis	No	No	No	No
30	8 yr	PMG	Tetraparesis	No	No	Yes	No
31	2 mo	SCZ	Hypotonia	No	No	Yes	No
32	7 yr	SCZ	Tetraparesis	No	No	No	No
33	17 yr	SCZ	Tetraparesis	No	Hypertension	No	No
34	10 yr	SCZ	Tetraparesis	No	No	No	No
35	1 yr	SCZ	Tetraparesis	No	No	No	No
36	18 yr	SCZ	Hypotonia	No	No	No	No
37	13 yr	SCZ	Tetraparesis	No	No	Yes	Yes
38	4 yr	SCZ	Tetraparesis	Yes	UTI	No	No
39	3 yr	SCZ	Tetraparesis	No	No	No	No
40	14 yr	SCZ	Tetraparesis	No	No	No	No
41	11 yr	SCZ	Tetraparesis	No	No	Yes	No
42	3 yr	SCZ	Tetraparesis	No	No	No	No
43	4 yr	SCZ	Tetraparesis	No	No	No	No
44	6 yr	SCZ	Tetraparesis	No	No	No	No
45	12 yr	SCZ	Tetraparesis	No	No	No	No
46	11 yr	SCZ	Tetraparesis	No	No	No	No
47	12 yr	SCZ	Tetraparesis	No	No	No	No
48	5 yr	SCZ	Tetraparesis	No	No	No	No
49	5 yr	SCZ	Hemiparesis	No	No	Yes	No
50	15 yr	SCZ	Hemiparesis	No	No	No	Yes
51	18 yr	SCZ	Hemiparesis	No	No	No	Yes
52	9 yr	SCZ	Hemiparesis	No	No	No	No
53	13 yr	SCZ	Hemiparesis	No	No	No	No
54	8 yr	SCZ	Hemiparesis	No	No	Yes	No
55	18 yr	SCZ	Hemiparesis	No	No	No	Yes
56	10 yr	SCZ	Hemiparesis	No	Hypertension	Yes	No
57	12 yr	SCZ	Hemiparesis	No	No	Yes	Yes
58	5 yr	SCZ	Hemiparesis	No	No	Yes	No
59	2 yr	SCZ	Hemiparesis	No	No	No	No
60	8 yr	SCZ	Hemiparesis	No	No	Yes	No
61	1 yr	SCZ	Hemiparesis	No	No	No	No
62	5 yr	SCZ	Hemiparesis	No	No	No	No
63	9 yr	SCZ	Hemiparesis	No	No	Yes	No
64	7 yr	SCZ	Hemiparesis	No	No	No	No
65	3 yr	SCZ	Hemiparesis	No	No	No	No
66	6 yr	SCZ	Hemiparesis	No	No	No	No
67	13 yr	SCZ	Hemiparesis	No	No	No	No
68	14 yr	SCZ	Hemiparesis	No	No	No	No
69	10 yr	SCZ	Hemiparesis	No	No	Yes	No
70	9 yr	SCZ	Hemiparesis	No	No	Yes	No

HMG = hemimegalencephaly; L/A-P = lissencephaly/agyria-pachygyria; MCD = malformation of cortical development; PMG = polymicrogyria; SCZ = schizencephaly; SLH = subcortical laminar heterotopia; UTI = urinary tract infection.

Characteristics of the Patients
ID	Age	Type of MCD	Neurologic Examination	↓ Fetal Movement	Other Pregnancy Complication	Intrapartum Complication	Diagnosed as Asphyxiated at Birth
1	1 yr	L/A-p	Hypotonia + cognitive deficit	No	No	No	No
2	12 yr	L/A-p	Tetraparesis + cognitive deficit	No	No	No	No
3	5 yr	L/A-p	Hypotonia + cognitive deficit	Yes	UTI	Yes	No
4	5 yr	L/A-p	Hypotonia + cognitive deficit	Yes	No	Yes	No
5	4 yr	L/A-p	Tetraparesis + cognitive deficit	No	No	No	No
6	1 yr	L/A-p	Hypotonia + cognitive deficit	No	No	Yes	No
7	9 yr	L/A-p	Cognitive deficit	Yes	No	No	No
8	12 yr	L/A-p	Cognitive deficit	No	No	Yes	No
9	3 yr	L/A-p	Tetraparesis + cognitive deficit	No	Alcohol abuse	No	No
10	1 yr	L/A-p	Cognitive deficit	Yes	No	No	No
11	6 mo	L/A-p	Hypotonia + cognitive deficit	No	No	No	No
12	8 yr	L/A-p	Hypotonia + cognitive deficit	No	No	No	No
13	18 yr	SLH	Cognitive deficit	Yes	No	Yes	Yes
14	11 yr	SLH	Cognitive deficit	No	Cardiac disease	No	No
15	17 yr	SLH	Cognitive deficit	No	No	No	No
16	2 yr	HMG	Hemiparesis	No	No	Yes	No
17	5 mo	HMG	Hemiparesis	No	No	No	No
18	11 yr	HMG	Hemiparesis	No	No	No	No
19	5 yr	HMG	Hemiparesis	No	No	Yes	No
20	7 mo	HMG	Hemiparesis	No	No	No	No
21	12 yr	PMG	Tetraparesis + mental retardation	Yes	Hypertension + diabetes	Yes	No
22	11 yr	PMG	Hemiparesis	No	No	No	No
23	3 mo	PMG	Hemiparesis	Yes	No	No	No
24	1 yr	PMG	Hemiparesis	No	No	No	No
25	3 yr	PMG	Hemiparesis	No	No	Yes	Yes
26	6 yr	PMG	Hemiparesis	No	No	No	No
27	6 yr	PMG	Hemiparesis	No	Alcohol and drug abuse	No	No
28	8 yr	PMG	Tetraparesis + pseudobulbar signs	No	No	No	No
29	4 yr	PMG	Tetraparesis	No	No	No	No
30	8 yr	PMG	Tetraparesis	No	No	Yes	No
31	2 mo	SCZ	Hypotonia	No	No	Yes	No
32	7 yr	SCZ	Tetraparesis	No	No	No	No
33	17 yr	SCZ	Tetraparesis	No	Hypertension	No	No
34	10 yr	SCZ	Tetraparesis	No	No	No	No
35	1 yr	SCZ	Tetraparesis	No	No	No	No
36	18 yr	SCZ	Hypotonia	No	No	No	No
37	13 yr	SCZ	Tetraparesis	No	No	Yes	Yes
38	4 yr	SCZ	Tetraparesis	Yes	UTI	No	No
39	3 yr	SCZ	Tetraparesis	No	No	No	No
40	14 yr	SCZ	Tetraparesis	No	No	No	No
41	11 yr	SCZ	Tetraparesis	No	No	Yes	No
42	3 yr	SCZ	Tetraparesis	No	No	No	No
43	4 yr	SCZ	Tetraparesis	No	No	No	No
44	6 yr	SCZ	Tetraparesis	No	No	No	No
45	12 yr	SCZ	Tetraparesis	No	No	No	No
46	11 yr	SCZ	Tetraparesis	No	No	No	No
47	12 yr	SCZ	Tetraparesis	No	No	No	No
48	5 yr	SCZ	Tetraparesis	No	No	No	No
49	5 yr	SCZ	Hemiparesis	No	No	Yes	No
50	15 yr	SCZ	Hemiparesis	No	No	No	Yes
51	18 yr	SCZ	Hemiparesis	No	No	No	Yes
52	9 yr	SCZ	Hemiparesis	No	No	No	No
53	13 yr	SCZ	Hemiparesis	No	No	No	No
54	8 yr	SCZ	Hemiparesis	No	No	Yes	No
55	18 yr	SCZ	Hemiparesis	No	No	No	Yes
56	10 yr	SCZ	Hemiparesis	No	Hypertension	Yes	No
57	12 yr	SCZ	Hemiparesis	No	No	Yes	Yes
58	5 yr	SCZ	Hemiparesis	No	No	Yes	No
59	2 yr	SCZ	Hemiparesis	No	No	No	No
60	8 yr	SCZ	Hemiparesis	No	No	Yes	No
61	1 yr	SCZ	Hemiparesis	No	No	No	No
62	5 yr	SCZ	Hemiparesis	No	No	No	No
63	9 yr	SCZ	Hemiparesis	No	No	Yes	No
64	7 yr	SCZ	Hemiparesis	No	No	No	No
65	3 yr	SCZ	Hemiparesis	No	No	No	No
66	6 yr	SCZ	Hemiparesis	No	No	No	No
67	13 yr	SCZ	Hemiparesis	No	No	No	No
68	14 yr	SCZ	Hemiparesis	No	No	No	No
69	10 yr	SCZ	Hemiparesis	No	No	Yes	No
70	9 yr	SCZ	Hemiparesis	No	No	Yes	No

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Intrapartum Complications Associated With Malformations of Cortical Development

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