 Hello everyone, presenting another interesting case. An MRI was performed for a 12 month old male child with history of motor developmental delay and seizures. He had previously undergone ultrasound and CT, which suggested the possibility of aqueductal stenosis causing obstructive hydrocephalus. Let us take a look at the images, T1 axial, T2 axial, T2 coronal, T2 societal. The MRI shows thickened bumpy dysplastic gyri with shallow sulky in bilateral cerebral hemispheres predominantly involving bilateral frontal parietal and temporal lobes. Gross ventricle amygallia is seen with spleying of corpus callus, there is possible hypoplasia or dysplasia of posterior body and spleenium of corpus callus, tectal plate is enlarged thickened and malformed, hypoplastic flattened pons is seen with prominent fourth ventricle and kinked pontomyzansophilic contour. Diffuse T2 flare hyperintensity is seen involving cerebral white matter bilaterally, suggesting abnormal malignation. Multiple subcortical cysts are seen in bilateral cerebral hemispheres. Mild protrusion of stereo uvil coat of bilateral orbits is seen, bumpy dysplastic gyri with shallow sulky in both cerebral hemispheres are consistent with polymicrogyria, mild protrusion of stereo uvil coat of bilateral orbits is consistent with posterior staphiloma. These findings along with ventricle amygallia, hypoplastic flattened pons, kinked pontomyzansophilic contour, enlarged thickened malformed tectal plate, abnormal malignation and multiple subcortical cysts in both cerebral hemispheres is suggestive of congenital muscular dystrophy, likely muscle eye brain disease. Congenital muscular dystrophies are a heterogeneous group of autosomal recessive myopathies presenting at birth with hypotonia, delayed motor development and early onset of progressive muscle weakness confirmed with a dystrophic pattern on muscle biopsy. Symptoms presenting symptoms are hypotonia, developmental delay, seizures and poor vision. The differential diagnosis for this case would be Fukuyama muscular dystrophy and Walker-Wauberg syndrome. All these dystrophies have overlapping findings on imaging and diagnosis is confirmed with genetic workup. In one article from AJNR, muscle eye brain disease is described to have cerebellar polymigrogaria with or without cysts, absence of septum pelucidum, diffuse cerebral cortical dysplasia, ontine and cerebellar vermin hypoplasia, tachyhypomylination, variable calosal hypogenesis and hydrocephalus. Fukuyama CMD to have diffuse central cerebral hypomylination, cerebellar polymigrogaria with or without cysts, frontal polymigrogaria, hypoplasia of pons and cerebellar vermis and in some cases occipital cobblestone cortex. Walker-Wauberg syndrome to have severe diffuse cobblestone cortex, complete absence of cerebral and cerebellar myelin, cerebellar polymigrogaria with or without cysts, ontine and cerebellar vermin hypoplasia, hydrocephalus and variable calosal hypogenesis.