Morphometry of the cerebral hemispheres in developmental dysphasia

A. de Grauw, Ch. Njiokiktjien (Amster- dam)

Anatomical asymmetries of the brain have been established for several structures. In right-hand- ed people the sylvian fissure curves up sharply on the right side and continues horizontally on the left. The planum temporale is larger on the left side and recently it has been shown that the width of the right hemisphere is larger in the frontal region and smaller in the occipital re- gion. It is assumed that these asymmetries re- present the usual dominance for symbolic speech function.

In developmental dyslexia an abnormal symmetry of the above mentioned structures has been demonstrated in some reports. How- ever, very often dyslexia is not an isolated dis- order, but it is part of a more generalized speech and language disorder: developmental dyspha- sia

Encephalitis lethargica in a child

A Gobin, J.C. Doelman, L.M.E. Smit (Heeze, Amsterdam)

An S-year-old girl presented with rise of temper- ature, somnolence, athetotic movements of the arms, an epileptic seizure and panick attacks in the acute phase of an unknown illness.

In three weeks she developed mutism, akine- sia and rigidity followed by focal epileptic sei- zures

Holocord astrocytomas in children, a case report

C.P.M. Grubben, J.S.H. Vles (Maastricht)

Intraspinal astrocytomas in children occur very infrequently. The incidence of CNS tumors in children is 2,4/100.000 per year and only 4% of these tumors are spinal cord astrocytomas.

Intraspinal astrocytomas are invariably multi- segmental and, according to Epstein and Ep- stein, holocord astrocytomas form a large sub- group (about 75%). This prevalence has not

We compared the curves of the sylvian fis- sures on both sides (horizontal and coronal cuts) and we measured the hemispheric width at sev- eral points on MRI-scans of 22 patients with developmental dysphasia. Eleven were non right-handed: four were left-handed and seven had no preference or were pathologically left- handed.

Six of the right-handers had a clearly asym- metric sylvian fissure (horizontal on the left). Compared to controls the patients had an ab- normal asymmetry. The right hemisphere tend- ed to be wider than the left, not only frontally, but also at the temporo-parietal regions. No evidence of damage was present on any MRI- scan.

Conclusion: morphometry of the brain in de- velopmental dysphasia shows an abnormal asymmetry, suggesting a compromised cerebral dominance.

The following year she functioned at a low mental level (idiocy). During that period we observed stereotyped movements.

Unexpectedly the situation altered drastical- ly. In a few months there were only residual signs and symptoms.

Prognosis, though, remains uncertain. The signs and symptoms meet the description

of encephalitis lethargica.

previously been recognized because of incom- plete neurodiagnostic studies.

Little is known about the biologic behaviour of intraspinal astrocytomas and their optimal treatment remains controversial.

Treatment of intraspinal astrocytomas in chil- dren, as opposed to that in adults, poses some specific, additional problems: surgical treat- ment more often than not causes spinal deformi- ties, radiation and chemotherapy cause much

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