[Moyamoya disease in twins].

Area of Science:

• Neurology
• Pediatric Neurology
• Vascular Neurology

Background:

• Moyamoya disease is a rare, progressive cerebrovascular disorder characterized by stenosis of the internal carotid arteries.
• Simultaneous onset of Moyamoya disease in twins is exceptionally rare, presenting unique diagnostic and management challenges.

Observation:

• Two ten-year-old twin sisters presented with concurrent symptoms suggestive of Moyamoya disease.
• Initial diagnostic workup included EEG and CT scans, with epilepsy and brain atrophy noted.
• Angiography revealed significant stenosis in the internal carotid arteries and characteristic moyamoya vessels.

Findings:

• Both twins experienced transient ischemic attacks (TIAs), including hemiweakness and loss of consciousness.
• Surgical intervention with encephalo-duro-arterio-synangiosis (EDAS) was performed bilaterally.
• Post-operative follow-up showed complete resolution of TIAs and a positive clinical outcome.

Implications:

• This case highlights the potential for simultaneous Moyamoya disease development in genetically predisposed individuals, such as twins.
• Early diagnosis and timely surgical revascularization, like EDAS, are crucial for preventing further ischemic events and improving prognosis.
• Further research into the genetic and environmental factors contributing to Moyamoya disease in familial cases is warranted.