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PubMed1999

Two female siblings with a previously unreported MCA/MR syndrome: pre- and postnatal growth retardation, iris colobomata, spasticity, facial dysmorphism and dilated ventricles.

We report two siblings from non consanguineous parents with a similar MCA/MR syndrome: Pre- and postnatal growth retardation, microcephaly, mental retardation, iris colobomata, facial dysmorphism, spasticity, dilated ventricles and abnormal immunoglobulin levels. Review of published reports and the use of the London Dysmorphology Database suggests that these siblings may present a new syndrome.

Abnormalities, Multiple↗

PubMedDate not supplied

Associated brain abnormalities in patients with corpus callosum anomalies.

Forty-nine patients with corpus callosum (CC) anomalies were evaluated in terms of the clinical features and magnetic resonance imaging (MRI) findings. CC anomalies were classified as CC agenesis: 6 (12%), CC hypogenesis: 5 (10%), and CC hypoplasia: 38 (78%). In the CC hypoplasia group the mean value of the genu thickness of the CC was 0.29 +/- 0.1 cm, which was less than the normal value of the age-matched normal children (normal range: 0.6-1.2 cm). The associated brain abnormalities were in five distinct groups: gray matter abnormalities, white matter abnormalities, midline brain structure defects, cortical atrophy, and encephalomalacia. There was no uniformity for the clinical spectrum of CC anomalies. Microcephaly, developmental delay and seizures were the prominent findings in patients. The clinical features were more severe in cases with associated brain anomalies.

Abnormalities, Multiple↗

PubMed2000

Norman-Roberts syndrome: prenatal diagnosis and autopsy findings.

We report on the autopsy findings of a male fetus in the 27th week of gestation with Norman-Roberts syndrome. The unaffected parents are first cousins and have a five-year-old child with a low, sloping forehead, broad and prominent nasal bridge, widely set eyes, severe psychomotor retardation, and an agyric cortex. Prenatal diagnosis showed a small head at the 25th week of gestation. At this time, a slowing-down of the growth of the sonographic measurements of the biparietal diameter and head circumference was found. Both the biparietal diameter (57 mm, <5th percentile) and the head circumference (207 mm, <5th percentile) showed a delay of at least two weeks in comparison with other non-cephalic somatometric parameters, that were normal for the gestational age (femur length: 46 mm=median value). After termination of pregnancy, post-mortem examination showed a normotrophic fetus with microcrania and marked microcephaly (brain weight: 50 g), low, sloping forehead, broad and prominent nasal bridge, and widely set eyes. The cerebral hemispheres displayed an almost completely smooth surface with poorly defined sylvian fissures and failure of operculization of the insula. Microscopic examination showed a predominantly four-layered cortex (lissencephaly type I). Karyotype was normal and in situ hybridization did not show any deletion in the Miller-Dieker/isolated lissencephaly critical region on 17p13.3. The syndromes with lissencephaly are reviewed.

Adult↗

PubMed1979

[The problems raised by the irradiation of pregnant women. Effects of ionizing radiations on the embryon and foetus (author's transl)].

In man, the period of maximum risk for the embryo and foetus is between the second and tenth week after conception. The most frequent and most severe malformation is microcephaly which in extreme cases is accompanied by mental retardation. The results of studies in experimental animals and man agree that it is impossible to demonstrate any increased risk of malformation with doses below 15 rads, and that the increase over the spontaneous incidence of malformation is slight at doses below 25 rads. A very small increase in the frequency of leukaemias and cancers has been observed after irradiation in utero for pelvimetry, which delivers a few rads; it can be estimated from these data that a dose of 2 rads induces at the most the risk of one case of cancer in 2,000 children. In practice, it is only exceptionally that an abortion is advised after a diagnostic radiological examination, since the doses in these circumstances are relatively low. A therapeutic termination of pregnancy should be advised when the dose is greater than 20 rads, but it is necessary to take into account other medico-social factors. Conversely, it is important to avoid any irradiation in women who could be pregnant and in particular avoid any irradiation of the true pelvis during the 10 days prior to menses and especially if there has been a delay in the start of menstruation. In pregnant women radiological examinations should only be made if they are of paramount importance for the mother, and all precautions taken to reduce the dose to the uterus in the absolute minimum.

Abnormalities, Radiation-Induced↗

PubMed2000

Head circumference is an independent clinical finding associated with autism.

Occipitofrontal circumference (OFC) is one of the few physical findings in autism that varies significantly from the norm and is distinct and measurable. As part of a study of genetic heterogeneity of autism, we scrutinized data from a large sample of patients with idiopathic autism (N = 137), using OFC as the categorizing variable. The OFC standard deviation (OFCSD) values of the autistic propositi (0.61+/-1.6) varied significantly from that of the normal population (0.0+/-1.0), (P<0.001). Comparison of the macrocephalic (OFCSD > 2.0, N = 32) with the normocephalic individuals (-2 SD < OFCSD < +2 SD, N = 95) showed no significant differences in sex ratio, morphological status, IQ, seizure prevalence, or recurrence risks. The macrocephalic individuals were slightly less apt than those with normocephaly to have a family history of Attention Deficit Hyperactivity Disorder (ADHD) (P<0.05). Each clinical subgroup of autism propositi, defined on the basis of phenotypic status, type of onset, seizure history, or IQ, had a higher than normal mean OFC indicating that macrocephaly is an independent clinical trait in autism. As in the non-autistic population, macrocephaly was highly familial with 45% of the macrocephalic and 37% of the normocephalic propositi having at least one macrocephalic parent. Microcephaly, however, was an independent significant variable that predicted the presence of other phenotypic or genetic traits and outcome. The microcephalic patients were more likely to have abnormal physical morphology, structural brain malformations, lower IQ, and seizures. Their sex ratio was closer to normal, and their relatives had a higher incidence of seizures.

Adolescent↗

PubMed1975

Intrauterine rubella, head size, and intellect.

The assumption that congenital rubella is commonly associated with microcephaly and mental retardation was examined. Among a rubella clinic population of 111 children, 92 children had vision sufficient to allow testing by the Leiter International Scale. The mean IQ for this group was 99.46 (SD, 19.5). Head circumference in this group correlated well with stature but poorly with intellect. The authors conclude that children with intrauterine rubella should be viewed as small children rather than children with small heads and that such children are poorly served if mental subnormality is assumed without careful study.

Body Height↗

PubMed1979

[Hypomelanosis of Ito: report of one case (author's transl)].

A case of hypomelanosis of Ito in a 22-month-old North African girl is reported. The family history is negative for skin disease. Whorls of depigmentation are present on the trunk and abdomen. Associated defects include: growth retardation, microcephaly, strabismus, bilateral epicanthus, myopia, hypertelorism and abnormalities of external ear. Associated non-cutaneous abnormalities documented in patients with hypomelanosis of Ito are reviewed.

Child, Preschool↗

PubMedDate not supplied

[Familial Pitt-Rogers-Danks: two new cases].

INTRODUCTION AND CLINICAL CASES: The Pitt Rogers Danks syndrome is characterized by prenatal and postnatal retardation of growth, mental retardation, microcephaly, convulsions and a peculiar facies. It is believed to represent a clinical variant of the Wolf Hirschhorn syndrome, since there is a deletion in the 4p16.3 region in both syndromes. We report two cases in the same family caused by maternal mal segregation of a 4:8 balanced translocation. We describe the clinical characteristics, investigations done and a review of the literature.

Child, Preschool↗

PubMed2001

[Frequency, dynamics, and structure of congenital malformations in populations under long-term exposure to ionizing radiation].

Information on the dynamics, frequency, and structure of congenital malformations (CMs) and chromosomal diseases in two generations of rural populations from the Semipalatinsk region was obtained for the first time. The tests performed in the Semipalatinsk nuclear test site (STS) for many years were demonstrated to deteriorate the genetic health of the populations of the zones of extreme and maximum radiation risks. Mutagenic and teratogenic effects of long-term ionizing irradiation were detected. These were mainly expressed as an increase in the frequencies of strictly registered CMs (SR CMs), including the Down syndrome, multiple malformations (MMs) and microcephaly (1.45 +/- 0.11, 1.39 +/- 0.01, and 0.77 +/- 0.05 per 1000 births, respectively). SR CMs exhibited linear trends toward higher frequencies in two generations of exposed persons after surface nuclear tests in 1949-1963. Their frequency was strongly correlated with the effective population dose of radiation; the main population genetic parameters (inbreeding coefficient, endogamy index, etc.) had less pronounced effects on Cms.

Abnormalities, Multiple↗

PubMed1975

Trisomy of the distal third of the long arm of chromosome 10. Report of a new case due to a familial translocation t(10;18) (q24;p11).

A new case of trisomy of the distal third of the long arm of chromosome 10 due to familial translocation t(10;18) (q24;p11) is described. The main clinical and radiological signs may be summarized as follows: growth at lower limits of normal; poor facial expression; round, flat face with high, broad forehead, fine, highly arched eyebrows, pseudohyperthelorism, microphthalmia, flat, broad bridged nose, hypoplasia of the bony structures of the central area of the face, "fish mouth", macroglossia, micrognathia; short neck; marked dextroconvex lumbar scoliosis; psychomotor delay of mild degree; selective, more pronounced speech delay. Our observation confirms the suggestion by Yunis and Sanchez that a clinical syndrome corresponds to this chromosomal alteration. However, some interesting differences from the previously reported cases, i.e., the absence of microcephaly and of severe impairment of growth and psychomotor development induce us to establish a more favorable prognosis in our case.

Abnormalities, Multiple↗

PubMed2002

Two siblings with a new Aicardi-Goutières-like syndrome.

We present two siblings (male and female) with very similar characteristics comprising dysmorphic features, severe developmental delay, progressive microcephaly, tonic seizures, and hypothyroidism. The male also had micropenis and cryptorchidism. Both children developed pericardial effusions which caused the death of the female at age 16 months. The male's cardiac function was stable at last follow-up at the age of 15 months. Cerebral imaging showed widespread intracranial calcifications, delay in myelination, hypoplasia of the corpus callosum, and cerebral atrophy. CSF examination showed normal CSF white-cell count and was negative for interferon, although a cytotoxic antibody was thought to be present. Other causes of a neurodegenerative condition and congenital infection were excluded. The combination of these features has not been described before. We believe that these patients represent a new syndrome which has some of the features of Aicardi-Goutières syndrome but is distinct from it.

Abnormalities, Multiple↗

PubMed1979

[Personal experience in monitoring examination of intracranial pressure].

In our Department of Neurosurgery, during the last two years, we have measured the intracranial pressure (IPC) with an extradural transducer, in cases of head trauma, subarachnoid haemorrhages, pseudotumor cerebri, dilated ventricles and microcephalies. We remark the importance of the continuous measuring of the ICP and its value in relation with the use of hyperosmolar solutions in the diagnosis, treatment and outcome of this patients.

Adult↗

PubMed2002

[Nijmegen breakage syndrome associated with pulmonary lymphoma].

Nijmegen breakage syndrome is a rare autosomal recessive disorder characterized by a peculiar dysmorphic syndrome (microcephaly, "bird-like" facies, short stature), combined immunodeficiency with recurrent infections, X-ray hypersensitivity and predisposition to malignancy, mainly lymphomas, as a consequence of chromosome instability due to anomalies in the repair of double-stranded DNA breaks.We present a 6-year-old boy with Nijmegen breakage syndrome, who developed a large B-cell non-Hodgkin's lymphoma, localized in the lung without nodal involvement.

Cell Cycle Proteins↗

PubMed2002

Clinical and diagnostic profile of agenesis of the corpus callosum.

This study reports the clinical profile, etiologies identified, and outcomes for a consecutive series of children with partial or complete agenesis of the corpus callosum. Children with agenesis of the corpus callosum were identified in a comprehensive computerized database of all patients seen in a single pediatric neurology practice over an 11-year interval. Medical records were then systematically reviewed. Twenty-four children with agenesis of the corpus callosum were identified of a total of 6911 children in the database (0.35%). Fifteen were male (62.5%); 9 (37.5%) had presented antenatally, 6 (25%) neonatally, and 9 (37.5%) postneonatally. Eight (33.3%) were microcephalic, 12 (50%) were dysmorphic, 11 (45.8%) had coexisting epilepsy, and 9 (37.5%) had a cerebral palsy variant. Investigations revealed an etiology in 11 (45.8%): 3 chromosomal abnormality, 3 metabolic disorder, 3 cerebral dysgenesis, and 2 genetic syndromes (Aicardi, Andermann). Outcomes identified included normal or mild developmental delay in 7 (29.2%) and moderate-severe developmental delay in the remaining 17 (70.8%). Factors predictive of successful etiologic determination on bivariate analysis included moderate-severe developmental delay or associated cerebral dysgenesis. Factors predictive of eventual developmental outcome included microcephaly, coexisting epilepsy, cerebral palsy, or cerebral dysgenesis. A spectrum of clinical presentations, underlying etiology, and developmental outcome is thus apparent in children with agenesis of the corpus callosum. An underlying etiology can be identified in slightly less than half of cases, and a normal or mildly delayed outcome is apparent in slightly less than a third. Factors predictive of identifying an underlying etiology or eventual outcome can be identified.

Agenesis of Corpus Callosum↗

PubMed1992

Neurological findings in HIV-infected children: a review of 49 cases.

Many HIV-infected children have neurological involvement. We present our observations in 49 cases, 58% of which had some form of clinical neurological impairment. Most of the patients affected (71%) presented with progressive encephalopathy, characterized by developmental delay with loss of acquisitions and cognitive decline, an impaired growth curve, microcephaly and corticospinal dysfunction. CT-scan imaging shows cerebral atrophy in all cases and basal ganglia calcifications in 29%. Non-specific abnormalities are found on the EEG in two-thirds of cases and in the CSF in slightly less than half the cases. Pathological studies sometime revealed HIV encephalitis or lateral corticospinal tracts degeneration. Neurological impairment secondary to vascular events, neoplasms or opportunistic infections were rare, especially when compared with the adult HIV population.

AIDS Dementia Complex↗

PubMed1992

Pregnancy outcome following exposure to angiotensin-converting enzyme inhibitors.

OBJECTIVE: Case reports of suspected adverse pregnancy outcomes associated with prenatal exposure to angiotensin-converting enzyme inhibitors, particularly oligohydramnios, prolonged neonatal anuria, and defects of ossification of the skull dome, prompted us to examine pregnancy outcome in a large cohort of pregnant women for whom complete drug exposure information was known. METHODS: We studied the prescribed drug exposure histories and pregnancy outcomes of all women aged 15-44 years enrolled in Tennessee Medicaid who delivered a live-born or stillborn infant between January 1, 1983 and December 31, 1988. RESULTS: Of the 106,813 women enrolled in Tennessee Medicaid who delivered either a live-born or stillborn infant during the study period, 19 were exposed to an angiotensin-converting enzyme inhibitor during pregnancy. All 19 women delivered live infants. Among the 19 newborns, one preterm infant had prolonged anuria necessitating dialysis and a second preterm infant had microcephaly and a large occipital encephalocele. CONCLUSIONS: These outcomes represent a systematic follow-up of all angiotensin-converting enzyme inhibitor-exposed pregnancies. Despite the small number of exposures, there were two outcomes previously linked to prenatal use of these drugs, suggesting that the absolute risk may be high. In light of these findings and the case reports of others, it is prudent to avoid the use of angiotensin-converting enzyme inhibitors in pregnancy.

Abnormalities, Drug-Induced↗

PubMedDate not supplied

Lenz microphthalmia syndrome with dental anomalies: a case report.

This report describes the dental management and 7-year follow-up of a 14-year-old boy who showed the typical characteristics of Lenz microphthalmia syndrome, a rare genetic disorder characterized by multiple abnormalities. The main features of the syndrome are microphthalmia, developmental retardation, ear abnormalities, microcephaly, skeletal, digital and urogenital anomalies. The dental anomalies include micrognathia, hypodontia, agenesis of permanent teeth, conic-shaped incisors, and taurodontic molars. The purpose of the report was to document specific oral manifestations and dental anomalies and their management associated with a previously reported case.

Abnormalities, Multiple↗

PubMed2003

[Severe cytomegalic inclusions disease in the fetus of a woman immunized before pregnancy].

After detection of a fetal microcephaly at 24 weeks gestation, we performed an amniocentesis at 29 weeks with chromosomal and polymerase chain reaction (PCR) search for viral contamination. Cytomegalovirus (CMV) infection was confirmed by PCR although the mother had previously been tested as immunized for CMV prior to conception. Abortion was induced; the fetus presented clinical CMV injuries confirmed by positive tissue culture (liver, brain and lungs). Recent publications have reported similar observations with variable viral strains. These findings point out the importance attentive search for ultrasonographic signs suggestive of fetal CMV infection.

Abortion, Induced↗