Congenital neurologic disorders

  • 文章类型: Case Reports
    背景:皮特-霍普金斯综合征(PTHS)是一种罕见的遗传综合征,与TCF4过渡因子变异引起的神经发育障碍和颅面畸形有关。本文的目的是报告两名诊断为PTHS的双胞胎婴儿的病例,通过从口腔拭子中提取的DNA鉴定TCF4基因中的杂合致病变体得到证实。
    方法:两名婴儿均表现为颅面不对称,并伴有变位峰和颅骨畸形。在诊断调查期间,对颅骨进行三维重建的计算机断层扫描显示,两个双胞胎的左冠状和异位缝线过早融合。他们在9个月大时使用多种技术进行了颅面重建。两种情况的术后结果均令人满意。
    结论:据我们所知,这是首例描述PTHS患儿复杂颅骨融合(CCS)发生的病例报告.需要进一步的研究来确定这里描述的PTHS和CCS的共同出现是否表明关联或偶然解释。
    BACKGROUND: Pitt-Hopkins syndrome (PTHS) is a rare genetic syndrome associated with neurodevelopmental disorders and craniofacial dysmorphisms caused by variations in the TCF4 transition factor. The aim of this article was to report the case of two twin infants diagnosed with PTHS, confirmed by the identification of a heterozygous pathogenic variant in the TCF4 gene through DNA extracted from a buccal swab.
    METHODS: Both infants presented with craniofacial asymmetry with a metopic crest and cranial deformity. During the diagnostic investigation, computed tomography with three-dimensional reconstruction of the skull showed premature fusion of the left coronal and metopic sutures in both twins. They underwent craniofacial reconstruction at the 9th month of age using a combination of techniques. The postoperative outcomes were satisfactory in both cases.
    CONCLUSIONS: To the best of our knowledge, this is the first case report to describe the occurrence of complex craniosynostosis (CCS) in children with PTHS. Further studies are needed to determine whether the co-occurrence of PTHS and CCS described here indicates an association or is explained by chance.
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  • 文章类型: Case Reports
    Meckel-Gruber综合征是一种以枕骨脑膨出为特征的致命性疾病,多囊肾,多指。在大多数情况下,它在产前被识别和终止。在这份报告中,作者介绍了一例Meckel-Gruber综合征合并Dandy-Walker畸形的病例。一名孕妇在妊娠第28周转诊,超声异常扫描显示后脑膨出和双侧肾脏增大。进一步的成像还显示第四脑室和小脑后脑脊液间隙之间的连通,之后,胎儿被诊断出患有Meckel-Gruber综合征和Dandy-Walker畸形。父母拒绝终止妊娠,后代过早出生,是该近亲家庭中Meckel-Gruber综合征的第二次复发。值得注意的是,在三种不同的怀孕中,在妊娠7个月前超声检查没有结果.尽管到目前为止Meckel-Gruber综合征最终是致命的,受影响新生儿的寿命变化很大。我们建议制定严重程度分类,以估计未终止病例的预期寿命。
    Meckel-Gruber syndrome is a lethal disorder characterized by occipital encephalocele, polycystic kidneys, and polydactyly. In most cases, it is identified and terminated antenatally. In this report, the authors present a case of Meckel-Gruber syndrome together with Dandy-Walker malformation. A pregnant woman referred at the 28th week of gestation with an abnormal ultrasound scan showing posterior encephalocele and bilaterally enlarged kidneys. Further imaging also indicated communication between the 4th ventricle and posterior cerebellar cerebrospinal fluid space, after which the fetus was diagnosed with Meckel-Gruber syndrome and Dandy-Walker malformation. Pregnancy termination was refused by the parents and the offspring was prematurely born to be the 2nd recurrence of Meckel-Gruber syndrome in this consanguine family. Remarkably, at the 3 different pregnancies, ultrasound was inconclusive before the 7th month of gestation. Though up to date Meckel-Gruber syndrome is ultimately lethal, the lifespan of affected newborns varied greatly. We suggest developing a severity classification to estimate life expectancy in unterminated cases.
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