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At least 19 recordsLinked to original sources
PubMed1993

Arthrogryposis, ophthalmoplegia, and retinopathy: confirmation of a new type of arthrogryposis.

Arthrogryposis multiplex congenita is a heterogeneous condition and many different types are clinically recognisable. Recently, a new type of autosomal dominant arthrogryposis was described in a father and son. We report on a male patient with similar clinical features, confirming this distinct type of arthrogryposis. The condition is characterised by congenital contractures of the hands and feet with diminished or absent phalangeal creases, ophthalmoplegia, a rigid trunk, deep set eyes, and (in the oldest patient) an abnormal electroretinogram. Differential diagnosis from amyoplasia, the different types of distal arthrogryposis, and symphalangism is discussed.

Adolescent↗
PubMed1982

Three distinct types of X-linked arthrogryposis seen in 6 families.

Six families with arthrogryposis (congenital contractures) inherited in an X-linked recessive manner are reported. Family histories from a study of over 350 patients with congenital contractures of the joints (arthrogryposis) were reviewed and of these, three probands had family histories consistent with X-linked recessive inheritance. Three other families were recognized through correspondence. Three forms of X-linked recessively inherited arthrogryposis are described: (1) Severe lethal X-linked arthrogryposis with severe contractures scoliosis deformities, hypotonia, and death due to respiratory insufficiency within 3 months of birth (1 family); (2) Moderately severe X-linked arthrogryposis with severe contractures, ptosis, microphallus, cryptorchidism, inguinal hernias, and normal intelligence (2 families); and (3) Resolving X-linked arthrogryposis with mild to moderate contractures at birth which improve dramatically with time (2 families and 1 sporadic case).

Arthrogryposis↗
PubMed1989

Familial distal arthrogryposis with craniofacial abnormalities: a new subtype of type II?

We report on 5 relatives in 3 generations with an apparent new type of distal arthrogryposis. These individuals have manifestations of type I distal arthrogryposis, but in addition, have craniofacial anomalies that include facial asymmetry, hypertelorism, downslanting palpebral fissures, high nasal bridge, malar hypoplasia, micrognathia, highly arched palate, notched chin, and posteriorly angulated ears. Their intelligence is normal. Although these manifestations preclude us from placing this family in the type I (isolated) distal arthrogryposis category, we also are unable to place them in any of the recognized subtypes of type II distal arthrogryposis. Thus, we think this family may have a previously undescribed form of autosomal dominant type II distal arthrogryposis.

Abnormalities, Multiple↗
PubMed1995

Dominant distal arthrogryposis in a Maori family with marked variability of expression.

The index case was a Maori bushman who presented with severe congenital spinal stenosis and manifestations of distal arthrogryposis. His offspring and 8 of his 9 sibs and most of their offspring were interviewed and examined. Of those examined 7 individuals with definite and 2 with probable distal arthrogryposis were identified in 4 of the families. A tenth relative with distal arthrogryposis and contractural arachnodactyly had died. There was marked variability in the severity and nature of manifestations with 2 having severe hand and foot involvement in addition to craniofacial changes compatible with a diagnosis of Freeman-Sheldon syndrome. Other apparently unrelated hereditary disorders in the family included ectrodactyly, biliary atresia, and Brachmann-de Lange syndrome. This is the first report of arthrogryposis in a Maori family.

Adult↗
PubMed1983

Neuropathologic findings in the spinal cords of 10 infants with arthrogryposis.

The lumbosacral cord segments of 10 infants with varying clinical forms of neurogenic arthrogryposis were compared with similar spinal cord segments from an infant with congenital contractures secondary to uterine constraint, 8 infants with Werdnig-Hoffman syndrome, and 11 age-matched controls. Neuronal numbers, sizes, and distribution were measured within the anterior horns. In addition to the classical reduction in the numbers of alpha motor neurons in both pathologic states, this study found the smaller neurons of the anterior horn were absent or diminished in Werdnig-Hoffman syndrome, while those cells were present in increased numbers with abnormal histology in all the patients with arthrogryposis. In 5 of the patients with arthrogryposis, the pathologic pattern was consistent throughout each cord segment; in 5 others, normal alpha neurons were retained and unequally distributed in the anterior horn segments. This unequal distribution predicted the muscle group involvement and suggested the mechanism for intrauterine joint fixation in these patients. The pathologic changes in the patients with arthrogryposis appear to be unique in spite of the heterogeneity of etiology and the clinical presentation.

Anterior Horn Cells↗
PubMed1983

A case of asymmetrical arthrogryposis--a clinical study and a preliminary report on the value of CT-scanning.

Following the introduction of the conception that arthrogryposis is a symptom and not a clinical entity, a case of the very rare asymmetric form of neurogenic arthrogryposis is presented. The asymmetry of congenital contractures and weakness is associated with hemihypotrophy. The value of muscular CT-scanning prior to muscle biopsy is demonstrated. Muscular CT-scanning shows the extension of adipose tissue, which has replaced damaged muscles and thereby indicates the exact site for muscle biopsy. Since orthopaedic treatment in arthrogryposis can be unrewarding due to severe muscular degeneration, preoperative scanning may provide additional important information on muscular function and thus be of benefit for surgery. The advantage of muscular CT-scanning in other forms of arthrogryposis requires further determination. The differential diagnosis with Werdnig-Hoffmann disease is discussed.

Arthrogryposis↗
PubMed1984

The heterogeneity of distal arthrogryposis.

A study of distal arthrogryposis is described including neurology, electromyography, cerebral and muscular CT-scanning, and muscle and nerve biopsies. In four cases presenting with congenital distal contractures, various neuromuscular disorders were diagnosed. They were respectively, congenital myopathy with core-like structures, congenital hypertrophic neuropathy, axonal neuropathy and anterior horn cell disease. The role of cerebral disorders in the pathogenesis of distal contractures is also considered. The significance of abnormal dermatoglyphics in the determination of the prenatal time of onset of congenital myopathies and arthrogryposis is discussed. Our findings provide evidence for the hypothesis that distal arthrogryposis may not be a distinct clinical entity with an autosomal dominant inheritance pattern, but a symptom, indicating various cerebral, neuromuscular and connective tissue disorders, present in numerous congenital syndromes with different modes of inheritance. In addition the value of electromyography, nerve conduction velocity studies, muscle and cerebral CT-scanning, and histology of muscle and nerve biopsies in the differential diagnosis of (distal) arthrogryposis is stressed.

Adolescent↗
PubMed1977

[2 cases of arthrogryposis].

The authors report two cases of arthrogryposis in two children of 7 1/2 and 13 years; the diagnostic criteria were those of Fisher, combining the joint limitations present since birth in at least two different regions, the absence of progressive neurological involvement, and evident amyotrophy. The different etiopathogenic theories are then discussed: review of the literature concerning cases of myopathic arthrogryposis is not very useful; the twelve cases mentioned in the literature are not homogenous, the histopathological findings were very variable, and the histoenzymological studies have been insufficient. The combination of neurological anomalies with arthrogryposis is undeniable (cerebral atrophy, depopulation of the anterior cornu, anterior radicular changes). They are not always present, however, and are insufficient to explain the symptoms. Consideration should be given to the question of whether the importance of the changes in the connective tissue are not underestimated: the proliferation of the connective tissue is, in fact, most of the time, the essential feature to be seen in a histological section. In connection with this "connective theory" it is important to recall the work of Ionasescu et al. (1970) who demonstrated in vitro the excessive synthesis of connective proteins in the muscles of patients with arthrogryposis.

Adenosine Triphosphatases↗
PubMed1986

Distal arthrogryposis type II: a family with varying congenital abnormalities.

Five family members with distal arthrogryposis in two generations are reported. Cleft lip and palate, micrognathia, ptosis, webbed neck, kyphoscoliosis, and short stature are seen in one or more affected family members. All individuals with distal arthrogryposis also have trismus. This family does not fit any of the recently proposed five subcategories of type II distal arthrogryposis, nor does it fit any other recognized autosomal dominant condition with distal contractures.

Arthrogryposis↗
PubMed1994

Arthrogryposis multiplex congenita: a report of two cases.

Arthrogryposis multiplex congenita refers to a group of birth defects characterised by multiple joint contractures. The syndrome is caused by neuropathic disease, myopathic disease, or any other cause of decreased fetal joint mobility. Multiple and usually symmetric joint abnormalities with associated muscular and soft tissue hypoplasia are noted at birth. A variety of associated congenital anomalies affecting many organ systems are frequently found. Ocular and orbital findings have been described in patients with arthrogryposis but corneal disease has only rarely been reported. We present corneal findings in two patients with arthrogryposis and discuss the implications for disease pathogenesis. Previous ophthalmologic reports are also reviewed.

Adolescent↗
PubMed1983

Arthrogryposis following maternal hypotension.

A case of arthrogryposis multiplex congenita is described, in which the pregnancy had been complicated by a prolonged hypotensive period on the 86th day of gestation. The similarity in pathological findings between ischaemic myelopathy and arthrogryposis suggest that maternal hypotension was an aetiological factor in this infant's arthrogryposis.

Arthrogryposis↗
PubMed1994

Epileptic seizures, arthrogryposis, and migrational brain disorders: a syndrome?

INTRODUCTION: Arthrogryposis multiplex congenita (AMC) may be associated with multiple developmental defects. In some severely affected newborns with AMC, autopsy studies have suggested a common mechanism of malmigration at the spinal and cerebral levels. To our knowledge, a constellation of arthrogryposis, epileptic seizures, and brain migrational anomalies in adult patients has not previously been described in a clinical material. MATERIAL AND METHODS: Six consecutive adult patients with arthrogryposis multiplex congenita and epileptic seizures form the basis of the present study. Five patients had joint contractures and reduced muscle volume restricted to the lower extremities, whereas one patient had predominantly upper extremity affection. They were studied with magnetic resonance imaging (MRI), EEG, EMG, a neuropsychological test battery, and chromosome analysis. RESULTS: Four of them had clear evidence of migrational brain disorders, demonstrated by MRI, in three of them roughly corresponding to the focal epileptiform EEG activity. Five of the patients had partial seizures, whereas one only had generalized tonic-clonic seizures. The MRI findings included polymicrogyria, pachygyria, and fused schizencephaly. Four had neurogenic EMG changes, one had myopathic EMG features, and one had an unremarkable EMG pattern in affected muscles. All patients with demonstrable migrational disorders showed abnormal neuropsychological features. Three patients were mentally retarded. A chromosome abnormality in the form of a ring chromosome 18 was present in one patient. CONCLUSION: We suggest that AMC, epileptic seizures, and migrational brain disorders may form the integral parts of a hitherto undescribed syndrome in adults. A wide-spread defect in neuronal migration along the entire neural axis may be the underlying mechanism of the cerebral and the peripheral symptoms.

Adolescent↗
PubMed1988

Neurogenic arthrogryposis multiplex congenita: clinical and muscle biopsy findings.

Thirteen cases of arthrogryposis multiplex congenita without evidence of spinal muscular atrophy, congenital muscular dystrophy, or structural myopathy were reviewed. Family history, consanguinity, pregnancy, delivery, number and severity of contractures, and outcome were evaluated. Laboratory investigations had been performed and a biopsy of muscle from an affected limb had been examined histochemically and by electron microscopy. Five biopsies showed fiber type 1 predominance and three had type 2 predominance. Patterns of fiber-type predominance may have resulted from altered neural influence leading to impaired maturation of type 1 or 2 motor units. Nine patients had been followed up for 3-8 years. Two were still not walking at age 8 years. For the 6 who were walking, the mean age at ambulation was 4.7 years. There was no deterioration in power. Muscle biopsy is recommended in arthrogryposis multiplex congenita. Identification of a probable neurogenic arthrogryposis multiplex congenita is important because the condition is not progressive and is apparently not transmitted genetically.

Arthrogryposis↗
PubMed1981

The 1960s epidemic of arthrogryposis multiplex congenita: a survey from the United Kingdom, Australia and the United States of America.

Arthrogryposis multiplex congenita is believed to be a specific clinical entity which is aetiologically unrelated to the "arthrogryposis-like" deformities of known neurological diseases such as myelomeningocele and myelodysplasia. The observation that the condition appeared to be three times as common in Melbourne, Australia, as in four centres in the United Kingdom (Wynne-Davies and Lloyd-Roberts 1976), prompted this survey of 132 patients: 73 from the United Kingdom, 34 from Australia and 25 from Wilmington, Delaware, USA. The survey aimed to established the same criteria for diagnosis in the three countries and to search for prenatal and genetic aetiological factors. It was shown that all centers treated more newborn children with this disorder during the 1960s than either before or after that period. All cases were sporadic and there was no family association with talipes equinovarus, congenital dislocation of the hip or hereditary neuromuscular disease. "Environmental" findings from all three centers were similar and it was concluded that arthrogryposis multiplex cogenita is a non-genetic disease of early pregnancy, associated with a variety of unfavourable intra-uterine factors. In addition, an unknown but possibly viral environmental agent may have been present to a significant extent only during recent decades and is now declining.

Abnormalities, Multiple↗
PubMed1976

[Contribution to the problem of Arthrogryposis multiplex (author's transl)].

A case of Arthrogryposis multiplex appearing after birth and of no characteristical course is described. It is shown that in respect to existing works for diagnosis of Arthrogryposis multiplex the insufficiency of the hitherto existing valid diagnostic criterions is obvious. This especially because the pathogenesis of Arthrogryposis multiplex is unknown. Trying to look for the condition of the connective tissue of our patient, it was found that the collagen of skin shows a young matter of polymerisation and a nearly correlating electron microscopical picture.

Adult↗
PubMed1990

A retrospective study of pregnancy complications among 828 cases of arthrogryposis.

828 cases with multiple congenital contractures (arthrogryposis) were categorized and histories were reviewed to identify pregnancy complications. 53.0% of cases had a specified diagnosis or known cause and no diagnosis was found for 47.0% of which 27.2% were though to probably have a genetic basis and 19.8% were of unknown etiology. Our data provides no evidence to support the suggestion that arthrogryposis is frequently a result of environmental or structural causes including uterine structural anomaly, intra-uterine infection, etc. Normal frequencies of bleeding, hormone treatment during gestation, amniotic fluid leakage, uterine anomaly, maternal illness, and maternal and paternal age were noted. Apparent, increased frequencies of twinning, severe nausea, polyhydramnios and oligohydramnios were observed. In particular, the frequency of polyhydramnios was dramatically increased among lethal cases (vs survivors) and thus, polyhydramnios appears to be a poor prognostic sign when associated with decreased fetal movement. Large case control studies with complete pregnancy histories are needed to confirm these results and to definitively identify pregnancy complications that are useful "flags" to indicate decreased fetal movement in utero and thus, aid in the identification of primary causes of arthrogryposis.

Arthrogryposis↗