Differential Diagnosis of Nervous System Disorders
- DORSAL INDUCTION ANOMALY
= defects of neural tube closure
- Anencephaly
- Cephalocele at 4 weeks
- Chiari malformation at 4 weeks
- Spinal dysraphism
- Hydromyelia
- VENTRAL INDUCTION ANOMALY
= defects in formation of brain vesicles + face
- Holoprosencephaly: 56 weeks
- Septo-optic dysplasia: 67 weeks
- Dandy-Walker malformation: 710 weeks
- Agenesis of septum pellucidum
- NEURONAL PROLIFERATION & HISTOGENESIS
- Neurofibromatosis: 5 weeks6 months
- Tuberous sclerosis: 5 weeks6 months
- Primary hydranencephaly: >3 months
- Neoplasia
- Vascular malformation (vein of Galen, AVM, hemangioma)
- NEURONAL MIGRATION ANOMALY
due to infection, ischemia, metabolic disorders
- Schizencephaly: 2 months
- Agyria + pachygyria: 3 months
- Gray matter heterotopia: 5 months
- Dysgenesis of corpus callosum: 25 months
- Lissencephaly
- Polymicrogyria
- Unilateral megalencephaly
- DESTRUCTIVE LESION
- Hydranencephaly
- Porencephaly
- Hypoxia: periventricular leukomalacia, germinal matrix hemorrhage
- Toxicosis
- Infections (TORCH)
- Toxoplasmosis
- Other: syphilis, hepatitis, zoster
- Rubella
- punctate / nodular calcifications
- porencephalic cysts
- occasionally microcephaly
- Cytomegalovirus inclusion disease
- typically punctate / stippled / curvilinear periventricular calcifications
- often hydrocephalus
- Herpes simplex
Absence of Septum Pellucidum
- Holoprosencephaly
- Callosal agenesis
- Septo-optic dysplasia
- Schizencephaly
- Severe chronic hydrocephalus
- Destructive porencephaly
Phakomatoses
[phako, Greek = lens / lentil-shaped object]
= NEUROCUTANEOUS SYNDROMES = NEUROECTODERMAL DYSPLASIAS
= development of benign tumors / malformations in organs of ectodermal origin (CNS, eye, skin)
- autosomal dominant:
- Neurofibromatosis (von Recklinghausen)
- Tuberous sclerosis (Bourneville)
- Retinocerebellar hemangioblastoma (Von Hippel-Lindau)
- Neurocutaneous melanosis
- not autosomal dominant:
- Encephalotrigeminal angiomatosis (Sturge-Weber-Dimitri)
- Ataxia-telangiectasia
Outline