PMC7720018_01
PMC7720018_02
Serial anthropometric assessment. Head circumference (HC), weight, and height were standardized for age using World Health Organization growth charts. Head circumference remains well below normal limits for age. Weight remains within normal limits at 2 and 15 months but declines to the lower end of the normal range by the age of 24 months. Length remains at the lower end of the normal range from 2 to 24 months.
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Suboptimal growth was observed on serial anthropometric assessments (Fig. 1) using WHO standards.
Magnetic resonance imaging (MRI) at 13 months (A-C). A: FLAIR axial view demonstrating enlarged lateral ventricles, predominantly in the right hemisphere. B: T1-weighted mid-sagittal view demonstrating intact corpus callosum and brain stem. C: T2-weighted coronal view demonstrating enlarged lateral ventricles and reduced cerebral volume, predominantly in the right hemisphere. D: Electroencephalography (EEG) at 16 months showing focal slowing (arrows) in left hemisphere.
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EEG data were transferred to a HIPAA compliant server for remote interpretation by 3 pediatric epileptologists (DD, GC, AP), using a standardized form. EEGs acquired at 15, 16, and 24 months showed bilateral, focal epileptiform activity in frontal regions and focal slowing in the left frontal region (Fig. 2D).