Bravo M, Chacón J, Bautista E, Pérez-Camacho I, Trujillo A, Grande M A
Servicio de Neurología, Hospital Universitario Virgen Macarena, Sevilla, España.
Rev Neurol. 1999;28(10):971-2.
Sotos syndrome is a form of infantile gigantism characterized by excessive body size from the time of birth, particular facies, acromegalic changes and signs of non-progressive cerebral involvement. The etiology is unknown. Diagnosis is based on somatometric data and the particular phenotype traits. Biochemical and endocrine studies are normal. Torticollis is a focal dystonia and therefore more common in adults.
A 20 year old woman with macrosomic features since birth presented with: weight 104 kg, height 182 cm; prognathism, hypertelorism, a broad over hanging forehead with a high hair line; large ears, hands and feet; torticollis towards the right with elevation and anteroversion of the right shoulder which caused symptomatic scoliosis. She was bradypsychic and rather slow in speech. The complementary tests done (cerebral and cervical CT and MR, bone gammography, evoked potentials, EMG-ENG, sural nerve biopsy, biopsy of skin and muscle, EEG and hormone and biochemistry studies) were normal. The torticollis was treated with botulinus toxin and improved considerably, as did the scoliosis.
To date, dystonia has not been described in association with Sotos syndrome. This may be a causal association, or even perhaps hereditary, since the patient's mother had dystonia (in the form of blepharospasm).
索托斯综合征是一种婴儿期巨人症,其特征为自出生起身体尺寸过大、特殊面容、肢端肥大症样改变以及非进行性脑受累体征。病因不明。诊断基于体格测量数据和特定的表型特征。生化和内分泌研究结果正常。斜颈是一种局限性肌张力障碍,因此在成年人中更为常见。
一名自出生起就有巨大儿特征的20岁女性,体重104千克,身高182厘米;下颌前突、眼距过宽、前额宽阔且发际线高;耳朵、手脚较大;向右侧斜颈,伴有右肩抬高和前倾,导致症状性脊柱侧弯。她智力迟缓,言语相当缓慢。所做的辅助检查(脑部和颈部CT及磁共振成像、骨闪烁造影、诱发电位、肌电图 - 神经电图、腓肠神经活检、皮肤和肌肉活检、脑电图以及激素和生化研究)均正常。斜颈采用肉毒毒素治疗后有明显改善,脊柱侧弯情况也有所改善。
迄今为止,尚未有关于索托斯综合征与肌张力障碍相关联的描述。这可能是一种因果关联,甚至可能具有遗传性,因为患者的母亲患有肌张力障碍(表现为眼睑痉挛)。