Dandy Walker malformation variant associated with refractory seizures in a 6-month-old baby: case report

Case presentation: Female, 6 months of age, only child unrelated parents. Born at term, weighing 3335 g, by uneventful cesarean delivery. At 2 the infant started with episodes seizures, bringing both arms close to trunk and pushing lower limbs back, happening once a day, lasting few seconds. There was ocular eversion during eventual drowsiness after them. Over time, worsening seizures observed her parents, an increase in daily frequency (ranging from 3 15 day) duration (1 minutes). Eventually, she had peripheral cyanosis which improved oxygen. She referred pediatric service optimize anticonvulsivant treatment, consisted Phenytoin 18 mg/kg/day, Valproic Acid 40 mg/kg/day Phenobarbital 4,5 mg/kg/day. Upon neurological examination, absence meningeal signs, axial force reducted, plantar/palm grip absent global hyperreflexia. The presented congenital malformation, irregular contours reduced dimensions right eyeball. A cranial MRI supratentorial region showed complete agenesis corpus callosum, increased lateral ventricles III ventricle, signs colpocephaly, presence subependymal nodular gray matter heterotopia ventricle frontal horn hippocampi rounded appearance, may be related poor rotation. In infratentorial region, exam visualization part inferior vermis, retrocerebellar fluid collection, that communicated fourth dimensions. Based on radiological findings, diagnosis Dandy Walker malformation (DWM) variant established. moment, is under clinical observation remains hospitalized control are still refractory, despite treatment 5 Carbamazepine 2% 35 mg/ml, Clobazam mg night, Levetiracetam for 12/12 hours. No other complaints or complications.