Neuropediatrics 2009; 40(6): 298-300
DOI: 10.1055/s-0030-1252050
Short Communication

© Georg Thieme Verlag KG Stuttgart · New York

Detection of Focal Cerebral Injury using Diffusion Tensor Magnetic Resonance imaging in a Boy with Becker Muscular Dystrophy

D.-W. Rha1 , E. S. Park1 , J. Kim2 , S. H. Kim3 , W. H. Chang3
  • 1Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
  • 2Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
  • 3Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
  • 4Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Further Information

Publication History

received 20.01.2010

accepted 17.03.2010

Publication Date:
05 May 2010 (online)

Abstract

Here, we report on a boy affected by both cerebral palsy and Becker muscular dystrophy (BMD). He had infrequently used his right hand since birth. But brain magnetic resonance imaging (MRI) taken at the age of 15 months showed no specific finding. Approximately 1 month later, muscle enzymes of his older brother were incidentally found to be elevated. The patient and his brother were diagnosed with progressive muscular dystrophy by gene analysis. At the age of 6 years, he underwent orthopedic surgery due to a right equinovarus deformity and BMD was confirmed by concomitant muscle biopsy. During the post-operative rehabilitation, clumsiness of the right hand was also observed. A follow-up brain MRI with diffusion tensor imaging (DTI) was taken. Although no responsible lesion was found on conventional MRI, DTI and fiber tractography revealed a decrease in the quantity of fibers in the left corticospinal tract. He was additionally diagnosed as having cerebral palsy.

References

  • 1 Ahn YH, Kim SH, Han BS. et al . Focal lesions of the corticospinal tract demonstrated by diffusion tensor imaging in patients with diffuse axonal injury.  NeuroRehabilitation. 2006;  21 239-243
  • 2 Amato AA, Dumitru D. Hereditary myopathies.. In: Dumitru D, Amato  AA, Zwarts MJ, (eds) Electrodiagnostic medicine. 2nd edn.. Philadelphia: Hanley & Belfus; 2002: 1265-1370
  • 3 Becker PE, Kiener F. A new x-chromosomal muscular dystrophy.  Arch Psychiatr Nervenkr Z Gesamte Neurol Psychiatr. 1955;  193 427-448
  • 4 Capute AJ, Shapiro BK. The motor quotient. A method for the early detection of motor delay.  Am J Dis Child. 1985;  139 940-942
  • 5 Einspieler C, Cioni G, Paolicelli PB. et al . The early markers for later dyskinetic cerebral palsy are different from those for spastic cerebral palsy.  Neuropediatrics. 2002;  33 73-78
  • 6 Jones MW, Morgan E, Shelton JE. et al . Cerebral palsy: introduction and diagnosis (part I).  J Pediatr Health Care. 2007;  21 146-152
  • 7 Kong E. Early detection and diagnosis of cerebral palsy.  Arch Ital Pediatr Pueric. 1967;  25 11-12
  • 8 Mori S, Crain BJ, Chacko VP. et al . Three-dimensional tracking of axonal projections in the brain by magnetic resonance imaging.  Ann Neurol. 1999;  45 265-269
  • 9 Mukherjee S, Gaebler-Spira DJ. Cerebral palsy.. In: Braddom  RL, Buschbacher RM, Chan  L et al (eds), Physical medicine and rehabilitation. 3rd ed.. Philadelphia: WB Saunders; 2007: 1243-1267
  • 10 Nakayama N, Okumura A, Shinoda J. et al . Evidence for white matter disruption in traumatic brain injury without macroscopic lesions.  J Neurol Neurosurg Psychiatry. 2006;  77 850-855
  • 11 Palisano R, Rosenbaum P, Walter S. et al . Development and reliability of a system to classify gross motor function in children with cerebral palsy.  Dev Med Child Neurol. 1997;  39 214-223
  • 12 Palmer FB. Strategies for the early diagnosis of cerebral palsy.  J Pediatr. 2004;  145 S8-S11
  • 13 Rosenbaum P, Paneth N, Leviton A. et al . A report: the definition and classification of cerebral palsy April 2006.  Dev Med Child Neurol Suppl. 2007;  109 8-14
  • 14 Son SM, Ahn YH, Sakong J. et al . Diffusion tensor imaging demonstrates focal lesions of the corticospinal tract in hemiparetic patients with cerebral palsy.  Neurosci Lett. 2007;  420 34-38

Correspondence

Won Hyuk ChangMD 

Department of Physical

Medicine and Rehabilitation

Samsung Medical Center

Sungkyunkwan University

School of Medicine 50

135-710 Irwon-dong

Gangnam-gu Seoul

Republic of Korea

Phone: +82/2/3410 2818

Fax: +82/2/3410 0052

Email: iamchangwh@narer.com

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