Neuroimaging studies were conducted in 15 children (11 boys), ages 4 to 14 years, with primary complaint of language delay, in a study at the Department of Neurology, University of Campinas, Brazil. Six with severe developmental language disorder (DLD) had diffuse perisylvian polymicrogyria (PMG): they did not speak or had mixed phonologic-syntactic deficit syndrome. Six with PMG restricted to posterior parietal regions had milder DLD, a phonologic programming deficit syndrome (excessive use of jargons). The clinical manifestations of DLD associated with polymicrogyria vary in relation to the extent of the cortical abnormality. [1]

COMMENT. Polymicrogyria involving perisylvian or temporoparietal regions may be associated with developmental language disorder (DLD) or developmental dyslexia. The complete perisylvian syndrome is manifested by pseudobulbar palsy, cognitive deficits, epilepsy, and MRI evidence of cortical abnormalities. In the above study, patients diagnosed with DLD and polymicrogyria had normal or borderline cognitive function and no history of epilepsy. A subtle form of posterior parietal polymicrogyria can present with DLD and represents a mild form of perisylvian syndrome.