MR imaging of schizencephaly

MR imaging was used to evaluate six patients who had schizencephaly, a disorder of cell migration characterized by holohemispheric, gray-matter-lined clefts. Clinically, these patients presented with intractable seizures and variable developmental delay. Although three of these patients had previous CT scans, the diagnosis was made only by MR. MR was more sensitive than CT in detecting the clefts as well as the accompanying abnormalities, including areas of pachygyria, polymicrogyria, and heterotopic gray matter. The possible pathogenesis of schizencephaly is discussed. MR provides excellent demonstration of the anatomic changes in schizencephaly.