[Cerebral polymicrogyria and 22q11 deletion syndrome]
G Arriola-Pereda1, A Verdú-Pérez, P de Castro-De Castro
1Sección de Neurología Infantil, Hospital General Universitario Gregorio Marañón, Madrid, España.
Insights
Children with 22q11.2 deletion syndrome may have brain malformations, including cortical dysplasia. Early diagnosis and study of these brain abnormalities are crucial for affected individuals.
Area of Science:
- Genetics
- Neurology
- Pediatrics
Background:
- 22q11.2 deletion syndrome (DiGeorge syndrome/CATCH 22) is linked to heart defects, facial anomalies, and developmental issues.
- Associated conditions include autism, learning disabilities, ADHD, and psychiatric disorders.
- Brain malformations are recognized but their prevalence and types are not well-defined.
Observation:
- A patient presented with congenital heart disease, psychomotor retardation, dysmorphic features, and microcephaly.
- Initial karyotype was normal, but later chromosomal analysis revealed a 22q11.2 deletion.
- Neuroimaging identified polymicrogyria-type cortical dysplasia in the right frontotemporal cortex.
Findings:
- This case highlights the association between 22q11.2 deletion and specific brain malformations like cortical dysplasia.
- It underscores the potential for subtle neurological signs and the need for advanced genetic testing.
- The study emphasizes that brain malformations can occur in individuals with 22q11.2 deletion.
Implications:
- Brain malformations should be investigated in all children diagnosed with 22q11.2 deletion syndrome.
- Cortical dysplasias should prompt consideration of 22q11.2 deletion.
- Further research is needed to determine the prevalence and spectrum of brain abnormalities in this syndrome.
Introduction:
Chromosome 22q11 microdeletion syndrome, DiGeorge syndrome or CATCH 22 spectrum, is characterised by conotruncal heart malformations, facial dysmorphisms, cleft palate, velopharyngeal insufficiency, transient hypocalcemia and T cell disorders. Furthermore, a significant number of patients may present autism-type developmental disorders, learning disabilities, attention deficit hyperactivity disorder or schizophrenia-like psychiatric problems.
Case Report:
A girl with congenital heart disease that had been treated surgically in the neonatal period, who presented psychomotor retardation, dysmorphic features and microcephaly. The conventional karyotype study that was performed at birth was normal. The physical examination revealed subtle signs of left hemiparesis. A neuroimaging study showed polymicrogyria-type cortical dysplasia that involved the right frontotemporal cortex. A chromosomal study was conducted and findings showed a 22q11.2 chromosome deletion.
Conclusions:
Brain malformations in children with deletion of the 22q11.2 chromosome have been reported previously, but their real prevalence and the most frequent type of malformation have not been properly determined. The authors conclude that brain malformations should be studied in all patients with 22q11.2 deletion and it should be borne in mind that all patients with cortical dysplasias may present this deletion.
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