Aicardi Syndrome

  • 文章类型: Case Reports
    Aicardi综合征是一种非常罕见的神经发育障碍,以X连锁优势状态遗传,伴有婴儿痉挛三联征,call体的部分或完全发育不全,和绒毛膜-视网膜\"空洞。“我们报告了一例女婴患有Aicardi综合征的经典三联征。一名女婴被送到联邦医学中心Birnin-Kebbi的儿科神经病学诊所,尼日利亚西北部,在两个月大的时候,有反复发作的发热性抽搐典型的婴儿痉挛。患者在足月分娩时具有正常的Apgar评分和人体测量学。检查显示婴儿无畸形特征且全身检查正常。然而,大脑的磁共振成像(MRI)显示call体完全发育不全,侧脑室和第三脑室后角扩张。眼底镜检查显示右眼沿血管拱廊有多个淡黄色斑点。左眼在与视盘相邻的上鼻象限中具有一个圆盘直径的腔隙,带有多个黄色斑点。诊断为Aicardi综合征。患儿口服苯巴比妥并随访。在18个月大的时候,孩子只能在没有支撑的情况下坐着,每只手里拿着一个物体,微笑社交,和胡言乱语。癫痫发作的频率也从每天>100次减少到每天2-3次,但是孩子出现了右侧痉挛性偏瘫。患者开始进行物理治疗,并维持抗癫痫药物。我们建议临床医生在任何出现婴儿痉挛的儿童的鉴别诊断中考虑Aicardi综合征。
    Aicardi syndrome is a very rare neurodevelopmental disorder, inherited as an X-linked dominant condition with a triad of infantile spasm, partial or complete agenesis of the corpus callosum, and chorio-retinal \"lacunae.\" We report a case of a female infant with the classical triad of Aicardi syndrome. A female infant presented to the Paediatric Neurology Clinic of the Federal Medical Centre Birnin-Kebbi, North-western Nigeria, at the age of two months with complaints of recurrent afebrile convulsions typical for infantile spasms. The patient was delivered at term with normal Apgar scores and anthropometry. Examination revealed an infant with no dysmorphic features and normal systemic examination. Magnetic Resonance Imaging (MRI) of the brain however, showed complete agenesis of the corpus callosum and dilatation of the posterior horn of the lateral and third ventricles. Fundoscopy showed multiple yellowish spots along the vascular arcades in the right eye. The left eye had a one-disc diameter lacuna in the superior nasal quadrant adjacent to the optic disc with multiple yellowish spots. A diagnosis of Aicardi syndrome was made. The child was placed on oral phenobarbital and followed up. At the age of 18 months, the child can only sit without support, hold an object in each hand, smile socially, and babble. The frequency of the seizures had also reduced from >100 episodes per day to 2-3 episodes per day, but the child had developed right-sided spastic hemiparesis. The patient was commenced on physiotherapy and the anti-epileptic drugs were maintained. We recommend clinicians consider Aicardi syndrome in the differential diagnosis of any child presenting with infantile spasms.
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  • 文章类型: Journal Article
    在神经肌肉活动受限的人中,治疗定位已经实施,以改善身体功能,避免继发性并发症,如挛缩和体形扭曲,通过恢复性睡眠优化身体能量。本案例研究描述了24小时姿势护理管理干预在患有Aicardi综合征的青春期前女孩中的应用。通过在使用定制模制轮椅座椅系统的基础上添加治疗床定位来进行干预。在与受试者的青春期(11-17岁)重叠的6年干预期内,在胸廓形状和对称性方面观察到明显改善。此外,受试者的母亲报告有规律的整晚不间断的睡眠,醒来时肌肉张力放松,咳嗽更强,充血更少,更有效的吞咽和零住院。24小时姿势护理管理干预为希望使用低风险神经肌肉活动障碍患者的家庭和护理人员提供了另一种选择,非侵入性,本地可用的方法来改善身体对称性,增加恢复性睡眠的时间,放松护理程序。24小时姿势护理管理的进一步研究,包括睡眠和休息的定位,对于有发生神经肌肉脊柱侧凸风险的复杂运动限制性残疾患者,应进行探讨.
    Among persons with neuromuscular mobility limitations, therapeutic positioning has been implemented to improve body function, avoid secondary complications such as contractures and body shape distortions, and optimize body energy through restorative sleep. This case study describes the application of a 24-hour posture care management intervention for a preadolescent girl with Aicardi syndrome. The intervention was administered by adding therapeutic bed positioning to use of a custom molded wheelchair seating system. Over the 6-year intervention period overlapping with the subject\'s adolescent years (age 11-17), marked improvement was observed in thoracic shape and symmetry. Moreover, the subject\'s mother reported regular full-nights of uninterrupted sleep, relaxed muscle tone upon waking, a stronger cough with less audible congestion, more efficient swallowing and zero hospitalizations. The 24-hour posture care management intervention offers an alternative option for families and caregivers of persons with neuromuscular mobility impairments who wish to use a low-risk, noninvasive, locally available approach to improve body symmetry, increase hours of restorative sleep, and ease caregiving routines. Further research in 24-hour posture care management, including positioning for sleep and rest, should be explored in individuals with complex movement limiting disabilities who are at risk of developing neuromuscular scoliosis.
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  • 文章类型: Case Reports
    未经证实:Aicardi综合征是一种神经发育障碍,其特征是call体部分或完全发育不全的三联症,婴儿痉挛,和病理脉络膜视网膜腔隙。
    未经批准:考试,多模态成像,基因检测用于指导诊断。
    未经证实:我们报告一例儿科患者,最初被诊断为难治性婴儿痉挛。患者对常规抗癫痫治疗无反应,全外显子组和线粒体基因组测序的基因检测无法确定根本原因,所以vigabatrin开始了.在麻醉下进行vigabatrin毒性筛查的眼科检查显示,双眼视网膜周围的脉络膜视网膜萎缩,左眼视神经有两个3盘直径脉络膜视网膜腔隙超颞侧和鼻下侧。鉴于call体发育不全伴多微陀螺的神经影像学表现和眼部表现,患者被诊断为Aicardi综合征。遗传测试揭示了Xp22基因座处的新重复事件。
    未经证实:Aicardi综合征,尽管是罕见的情况,在调查儿童早期难治性癫痫的女性儿童时,应始终考虑鉴别诊断。基因检测可以帮助我们进一步了解AIS和寻找遗传病因。
    UNASSIGNED: Aicardi syndrome is a neurodevelopmental disorder characterized by a triad of partial or complete agenesis of the corpus callosum, infantile spasms, and pathognomonic chorioretinal lacunae.
    UNASSIGNED: Examination, multimodal imaging, and genetic testing were used to guide diagnosis.
    UNASSIGNED: We report a case of a pediatric patient who was initially diagnosed with refractory infantile spasms. The patient was unresponsive to conventional antiepileptic therapy, and genetic testing with whole exome and mitochondrial genome sequencing could not identify the underlying cause, so vigabatrin was initiated. The ophthalmic examination under anesthesia for vigabatrin toxicity screening revealed chorioretinal atrophy in the retinal periphery of both eyes, with two 3-disc diameter chorioretinal lacunae superotemporal and inferonasal to the optic nerve in the left eye. Given the neuroimaging findings of corpus callosum hypoplasia with polymicrogyria and ocular findings, the patient was diagnosed with Aicardi syndrome. Genetic testing revealed a novel duplication event at the Xp22 locus.
    UNASSIGNED: Aicardi syndrome, albeit a rare condition, should always be considered in the differential diagnosis when investigating a female child with refractory seizures in early childhood. Genetic testing may help further our understanding of AIS and the search for a genetic etiology.
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  • 文章类型: Case Reports
    背景:Aicardi综合征是一种遗传性畸形综合征,具有call体发育不全或发育不全的三联症,独特的脉络膜视网膜腔隙和婴儿痉挛。这是一种罕见的发育障碍,最早于1965年描述。该疾病影响100,000个活产中的1个。
    方法:我们描述了一个诊断为Aicardi综合征的34个月大女孩。
    方法:根据眼底彩色图像的结果,病史以及核型和DNA微阵列分析,患者被诊断为Aicardi综合征。
    方法:另外还进行了B超和电生理检查。
    结果:眼底镜检查显示双眼视盘缺损,后极广泛的脉络膜视网膜腔隙伴视网膜色素上皮重组和萎缩。闪光视觉诱发电位(FVEP)P2振幅低于正常范围。B超检查显示视盘病变与视盘缺损一致。
    结论:先天性中枢神经系统畸形患儿应定期进行眼科检查,以利于诊断和判断视功能发育的预后。
    BACKGROUND: Aicardi syndrome is a genetic malformation syndrome with a triad of dysgenesis or agenesis of the corpus callosum, distinctive chorioretinal lacunae and infantile spasms. It is a rare developmental disorder first described in 1965. The disease affects 1 in 100,000 live births.
    METHODS: We describe a 34-month-old girl diagnosed with Aicardi Syndrome.
    METHODS: Based on the results of color images of the fundus, medical history as well as the analysis of karyotype and DNA microarrays, the patient was diagnosed with Aicardi\'s syndrome.
    METHODS: Additionally an B-scan ultrasonography and an electrophysiological test was performed.
    RESULTS: Fundoscopic examination revealed optic disc colobomas in both eyes, extensive chorioretinal lacunae at the posterior pole with retinal pigment epithelium regrouping and atrophy. Flash visual evoked potentials (FVEP) P2 amplitude was lower than normal range. B-scan ultrasonography revealed an optic disc lesion consistent with optic disk coloboma.
    CONCLUSIONS: Children with congenital central nervous system malformations should undergo regular ophthalmic checkups to facilitate diagnosis and determine prognosis of visual function development.
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  • 文章类型: Case Reports
    Aicardi综合征是一种X连锁显性遗传病,几乎只存在于女性中。为了诊断Aicardi综合征,call体发育不全的经典三合会,婴儿痉挛,脉络膜视网膜腔隙必须存在.这里,我们描述了一例妊娠36周时分娩的女性新生婴儿,手臂和腿部僵硬,到达急诊科;因此,进行了脑电图检查,显示广义的polypots确认婴儿痉挛。此外,进行了磁共振,显示call体完全发育不全。然后患者被转移进行检眼镜检查,这证明了与脉络膜视网膜腔隙相对应的多个色素减退的脉络膜视网膜病变。根据临床和放射学发现,确定了Aicardi综合征的诊断,开始抗惊厥治疗和物理治疗。该病例报告强调了临床医生怀疑这种罕见遗传病应考虑的主要特征,强调影像学和脑电图检查结果。
    Aicardi syndrome is an X-linked-dominant genetic condition that is present almost exclusively in females. To diagnose Aicardi syndrome, the classic triad of agenesis of the corpus callosum, infantile spasms, and chorioretinal lacunae must be present. Here, we described a case of a female newborn baby delivered at 36 weeks of gestation that arrived at the emergency department with stiffening of arms and legs; therefore, an electroencephalogram was performed, showing generalized polypots confirming infantile spasms. Moreover, magnetic resonance was performed, showing complete agenesis of the corpus callosum. The patient was then transferred for an ophthalmoscopic examination, which evidenced multiple hypopigmented chorioretinal lesions corresponding to chorioretinal lacunae. Based on the clinical and radiological findings, the diagnosis of Aicardi syndrome was established, and treatment with anticonvulsive therapy and physiotherapy was initiated. This case report highlights the main characteristics that clinicians should consider to suspect this rare genetic condition, emphasizing the imaging and electroencephalographic findings.
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  • 文章类型: Case Reports
    未经证实:报告一例罕见的Aicardi综合征,其右眼周边视网膜无灌注并伴有360度新生血管形成,左眼茎组织伴有乳头周围纤维血管膜和牵张性视网膜脱离(TRD)。
    UNASSIGNED:一名一个月大的女孩因脑部磁共振成像异常而被转诊接受眼科评估,以确认诊断为Aicardi综合征。右眼存在360度周围无血管视网膜,伴有广泛的新生血管形成。在左侧眼底发现有纤维血管增生引起TRD的茎组织。右眼的视网膜在完成周边激光光凝后变得静止。左眼脱离的视网膜变平了,在手术切除牵引一年后,乳头周围脉络膜视网膜腔隙变得可见。此外,左眼的轴向长度增长恢复。
    UNASSIGNED:这是一例罕见的Aicardi综合征,其中一只眼并发乳头状周围纤维血管牵引,另一只眼周边视网膜无灌注。手术干预不仅对于消除牵引和使视网膜变平至关重要,而且对于促进眼球的持续生长至关重要。
    UNASSIGNED: To report a rare case of Aicardi syndrome presenting with concurrent peripheral retina nonperfusion with 360-degree neovascularization in the right eye and stalk tissue with a peripapillary fibrovascular membrane and tractional retinal detachment (TRD) in the left eye.
    UNASSIGNED: A one-month-old girl was referred for an ophthalmic evaluation to confirm the diagnosis of Aicardi syndrome due to abnormal brain magnetic resonance imaging. A 360-degree circumferential peripheral avascular retina with extensive neovascularization was present in the right eye. Stalk tissue with fibrovascular proliferation causing TRD was found in the left fundus. The retina of the right eye became quiescent after completing peripheral laser photocoagulation. The detached retina in the left eye was flattened, and the peripapillary chorioretinal lacunae became visible one year after surgical removal of the traction. In addition, the axial length growth of the left eye regained.
    UNASSIGNED: This is a rare case of Aicardi syndrome with concurrent peripapillary fibrovascular traction in one eye and peripheral retina nonperfusion in the other eye. Surgical intervention is vital not only for removing the traction and flattening the retina but also for promoting continual growth of the eyeball.
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  • 文章类型: Journal Article
    To characterize a suggestive prenatal imaging pattern of Aicardi syndrome using ultrasound and MR imaging.
    Based on a retrospective international series of Aicardi syndrome cases from tertiary centers encountered over a 20-year period (2000-2020), we investigated the frequencies of the imaging features in order to characterize an imaging pattern highly suggestive of the diagnosis.
    Among 20 cases included, arachnoid cysts associated with a distortion of the interhemispheric fissure were constantly encountered associated with complete or partial agenesis of the corpus callosum (19/20, 95%). This triad in the presence of other CNS disorganization, such as polymicrogyria (16/17, 94%), heterotopias (15/17, 88%), ventriculomegaly (14/20, 70%), cerebral asymmetry [14/20, 70%]) and less frequently extra-CNS anomaly (ocular anomalies [7/11, 64%], costal/vertebral segmentation defect [4/20, 20%]) represent a highly suggestive pattern of Aicardi syndrome in a female patient.
    Despite absence of genetic test to confirm prenatal diagnosis of AS, this combination of CNS and extra-CNS fetal findings allows delineation of a characteristic imaging pattern of AS, especially when facing dysgenesis of the corpus callosum.
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  • 文章类型: Case Reports
    UNASSIGNED: Aicardi syndrome is an X-linked condition that is associated with multiple ophthalmic malformations. Here, we report the first published fluorescein angiography (FA) study of a morning glory optic nerve in a patient with Aicardi syndrome and contralateral persistent fetal vasculature (PFV).
    UNASSIGNED: A 12-day old full-term baby girl with a normal neurological exam was referred for evaluation of microphthalmia. The posterior segment of the right eye demonstrated chorioretinal lacunae typical of Aicardi syndrome and microphthalmos with a stalk consistent with PFV. The right eye imaging could not be captured due to the severe microphthalmos and cataract, however, fluorescein angioscopy was performed. The left eye demonstrated a morning glory appearing optic disc with peripapillary chorioretinal lacunae. Fluorescein angiography of the eye showed and late staining in the areas of ellipsoid chorioretinal lacunae emanating from the optic nerve and extensive peripapillary staining and late leakage of the optic nerve.
    UNASSIGNED: Patients with Aicardi syndrome can have morning glory optic nerve anomaly and PFV. Using FA under anesthesia to detect these abnormalities help in estimating the extend of the disease and its complications, which allows for better management of the complications.
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  • 文章类型: Case Reports
    Aicardi综合征是一种严重的神经发育障碍,主要发生在女性,以癫痫发作为特征,call体的发育不全,和脉络膜视网膜腔隙,在大多数受影响的个体中一起发生。癫痫发作始于婴儿期,并倾向于强度发展,并且通常对标准的多模式药物治疗难以治疗。
    我们在这里介绍一个独特的案例,一个12岁的女孩,她患有call体部分发育不全,接受了call体切开术治疗药物难治性癫痫。这样做,我们还回顾了有关这些独特患者的神经外科治疗的文献.
    对于部分存在的孩子的子集,而不是完整的,call体的发育不全,骨体切开术应被视为减少癫痫发作负担的治疗选择.
    Aicardi syndrome is a severe neurodevelopmental disorder that occurs primarily in females and is characterized by seizures, agenesis of the corpus callosum, and chorioretinal lacunae, which occur together in the majority of affected individuals. Seizures begin in infancy and tend to progress in intensity and are often refractory to standard multimodal medication treatments.
    We present here a unique case of a 12-year-old girl with partial agenesis of the corpus callosum who underwent a corpus callosotomy for treatment of medically refractory epilepsy. In so doing, we also review the literature with regard to the neurosurgical management of these unique patients.
    For the subset of children who present with partial, rather than complete, agenesis of the corpus callosum, corpus callosotomy should be considered as a treatment option to reduce seizure burden.
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  • 文章类型: Case Reports
    脉络丛乳头状瘤(CPPs)很少见,可以出现在幼儿中的良性肿瘤。大多数儿科患者出现脑积水的迹象,需要立即治疗。没有脑积水的儿童脉络丛肿瘤的自然史定义不清。在这份报告中,作者介绍了一个非常罕见的病例,一个没有脑积水的儿童,但在出生后不久发现了两个脑室内脉络丛肿瘤。已对癫痫发作进行了初步成像,并显示出call体发育不全并增强了第三和左侧脑室的肿瘤。序贯成像显示两种肿瘤的快速生长。当孩子3个月大时,切除了外侧肿瘤。标本的组织学检查显示良性特征,有丝分裂率升高。鉴于患者的年龄在3岁以下,诊断为WHOI级CPP.第三脑室肿瘤生长迅速。进行了第二次手术,并切除了该肿瘤。再一次,病理诊断为WHOⅠ级CPP。作者介绍了这一罕见病例,并讨论了当前的相关文献。
    Choroid plexus papillomas (CPPs) are rare, benign tumors that can arise in young children. Most pediatric patients present with signs of hydrocephalus and require immediate treatment. The natural history of choroid plexus tumors in children without hydrocephalus is poorly defined. In this report, the authors present the very rare case of a child without hydrocephalus but with two intraventricular choroid plexus tumors discovered shortly after birth. Initial imaging had been performed for seizures and showed agenesis of the corpus callosum and enhancing tumors in the third and left lateral ventricles. Sequential imaging demonstrated rapid growth of both tumors. The lateral tumor was removed when the child was 3 months of age. A histological examination of the specimen showed benign features with an elevated mitotic rate. Given the patient\'s age of under 3 years, the diagnosis was WHO grade I CPP. The third ventricle tumor grew rapidly. A second surgery was performed and this tumor was resected. Again, the pathological diagnosis was WHO grade I CPP. The authors present this rare case and discuss the current relevant literature.
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