-Septo-optic dysplasia (SOD) is a syndrome composed by optic nerve and septum pellucidum dysgenesis. It has been classified into two subsets according to the embryogenesis and the neuropathological findings. Basically, the difference between these two groups is the presence or not of schizencephaly. The term SOD-Plus was recently proposed to describe SOD associated with cortical dysplasia. We report a 6-month-old female patient who presented absent visual fixation since 4 months of age and delayed psychomotor development. Neurological examination demonstrated spastic left hemiparesis and ophtalmological evaluation revealed bilateral optic disc hypoplasia. The head computed tomography (CT) scan showed absence of the septum pellucidum, ventricular asymmetry and schizencephaly. The magnetic resonance imaging (MRI) showed complete absence of the septum pellucidum associated to optic nerves and chiasma atrophy, schizencephaly and cortical dysplasia. The patient underwent an evoked potential examination with flash stimulation, which revealed bilateral absence of cortical evoked potential. She was referred to visual stimulation and physiotherapy. We emphasize the neuroimaging of this syndrome and stress the importance of the clinical investigation for patients with septum pellucidum dysgenesis on MRI or CT scans.KEY WORDS: magnetic resonance imaging, computed tomography, septo-optic dysplasia, septum pellucidum. Displasia septo-óptica plus: relato de casoRESUMO -A displasia septo-óptica (DSO) é síndrome composta por disgenesia do nervo óptico e do septo pelúcido, que pode ser dividida em dois subgrupos de acordo com sua embriogênese e achados neuropatológicos. A diferença básica entre estes dois grupos é a presença ou não de esquizencefalia. O termo DSO-plus foi proposto recentemente para descrever DSO associada a displasia cortical. Apresentamos uma paciente de 6 meses de idade com ausência de fixação visual desde os 4 meses e atraso do desenvolvimento psicomotor. O exame neurológico demonstrou hemiparesia espástica esquerda e a avaliação oftalmológica revelou hipoplasia do disco óptico bilateralmente. A tomografia computadorizada (TC) de crânio demonstrou ausência de septo pelúcido, assimetria ventricular e esquizencefalia. A ressonância magnética (RM) revelou ausência completa de septo pelúcido associada a atrofia dos nervos e quiasma ópticos, esquizencefalia e displasia cortical. A paciente foi submetida a exame de potencial evocado com estimulação por flashes que revelou ausência bilateral de potencial evocado cortical. Terapia paliativa foi iniciada com estimulação visual e fisioterapia. Os autores enfatizam os achados de neuro-imagem desta síndrome e a importância da investigação clínica e por métodos de imagem (TC e RM) em pacientes com disgenesia do septo pelúcido. PALAVRAS-CHAVE: ressonância magnética, tomografia computadorizada, displasia septo-óptica, septo pelúcido.
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