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Abstract
Using magnetic resonance imaging (MRI), we studied the myelination of the brains of
8 patients with West syndrome. All cases were symptomatic, 2 having severe asphyxia,
1 lissencephaly, 1 Leigh encephalopathy, 2 tuberous sclerosis, 1 multiple anomalies
and 1 microcephaly. Myelination of the pons, cerebellum, thalamus, internal capsules,
optic radiation, centrum semiovale and cerebral white matter was separately assessed.
The 2 cases with tuberous sclerosis exhibited normal myelination patterns, although
asymmetry of the cerebral white matter was noted. These cases had a moderate degree
of mental retardation and persistent seizures. The other 6 cases exhibited a marked
delay of myelination throughout the central nervous system except for the midbrain.
These cases had severe psychomotor retardation and persistent seizures. Although the
difference in the outcome may simply reflect the different etiological disorders,
these results suggest that the myelination pattern is related to the psychomotor retardation
but not to the severity of the seizures in West syndrome. Atrophy of the corpus callosum
developed during ACTH therapy and disappeared after the therapy. It was thus suggested
that the callosal atrophy caused by the ACTH therapy was reversible.
Keywords
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Article info
Publication history
Accepted:
October 22,
1995
Received:
March 9,
1995
Identification
Copyright
© 1996 Elsevier Science B.V. All rights reserved. Published by Elsevier Inc.