Walker-Warburg syndrome with skeletal muscle involvement. A report of three patients

Three patients with Walker-Warburg syndrome are reported. In all, severe hypotonia and ocular abnormalities were noted soon after birth, followed by a rapid increase of head size. Examination of the brain showed regions of complete agyria, cortical dysplasia of the cerebrum, cerebellar micropolygyria, marked hydrocephalus and aqueduct stenosis. In skeletal muscles, advanced myopathy consistent with dystrophic change was present. The cortical dysplasia in this syndrome is similar to the severest pattern of the cortical dysplasia seen in Fukuyama congenital muscular dystrophy, but ocular abnormalities are rare in the latter. These two syndromes may be genetically distinct, despite the presence of cortical dysplasia and myopathy in both.