Unique Presentation of Colpocephaly in a Preterm Triplet: A Case Report

Colpocephaly is a rare congenital cerebral malformation characterised by disproportionate dilatation of the occipital horns of the lateral ventricles, most commonly associated with partial or complete agenesis of the corpus callosum. It results from defective neuronal migration and abnormal white-matter development during embryogenesis. The condition may manifest during infancy with developmental delay, seizures, and varying degrees of intellectual or visual impairment. Present case report a 10-month-old male infant, the first-born of triplets conceived through in-vitro fertilisation, who presented with global developmental delay and recurrent seizures. The perinatal period was complicated by respiratory distress and neonatal sepsis, necessitating ventilation and intensive care. MRI brain revealed thinning of the corpus callosum, bilateral cerebral volume loss, and disproportionate enlargement of the occipital horns-findings consistent with colpocephaly. The infant was managed with physiotherapy, occupational therapy, and speech therapy, leading to gradual improvement in tone, posture, and social interaction on follow-up. Antiepileptic therapy was continued with good seizure control. This case is unique due to the coexistence of colpocephaly, prematurity, perinatal depression, and neonatal sepsis in a triplet born via assisted reproduction- an extremely uncommon combination. The report underscores the multifactorial aetiopathogenesis of neurodevelopmental impairment in such cases. Early recognition, timely neuroimaging, and multidisciplinary intervention play a vital role in optimising outcomes and providing appropriate parental counselling.