Kopyta Ilona, Jamroz Ewa, Marszal Elzbieta, Kluczewska Ewa
Z Katedry i Kliniki Pediatrii i Neurologii Wieku Rozwojowego Slaskiej Akademii Medycznej, Katowice..
Wiad Lek. 2006;59(7-8):471-6.
Schizencephaly is a rare central nervous system malformation. The anomaly is characterized by uni- or bilateral clefts in the brain's cerebral hemispheres. There are 2 types of the anomaly distinguished: type I ("closed lips") if there are fused clefts in cerebral mantle and type II ("open lips") if the clefts are separated. The etiology of this malformation is not clear; both environmental (intrauterine cytomegaloviral infection) and genetic risk factors are considered (mutations in EMX2, Lhx2 genes). The aim of the study was the analysis of clinical presentation, neurodevelopment progress and seizures in children with schizencephaly.
We examined 9 children (4 girls, 5 boys) at the age of 3 months to 11 years at the time of schizencephaly diagnosis. The neuroimaging (computed tomography--CT or/and magnetic resonance imaging--MRI) was performed in all of the patients. We found bilateral schizencephaly in 7 patients and unilateral in 2 of them; in 5 patients the brain anomalies other than schizencephaly were found. Epileptic seizures are present in 7 patients; in 2 of them the epilepsy is drug resistant. The development is delayed in all our patients, in spite of one.
Schizencephaly is a severe brain malformation almost always leading to developmental delay and epilepsy. We did not found the correlation between the type of anomaly and clinical course, the degree of developmental delay and the severity of epilepsy in our group patients.
脑裂畸形是一种罕见的中枢神经系统畸形。该异常的特征是大脑半球出现单侧或双侧裂隙。这种异常可分为2种类型:I型(“唇闭合”),即脑皮质裂隙融合;II型(“唇开放”),即裂隙分离。这种畸形的病因尚不清楚;环境因素(宫内巨细胞病毒感染)和遗传危险因素(EMX2、Lhx2基因突变)均被考虑。本研究的目的是分析脑裂畸形患儿的临床表现、神经发育进程和癫痫发作情况。
我们对9例脑裂畸形诊断时年龄在3个月至11岁的患儿(4例女孩,5例男孩)进行了检查。所有患者均进行了神经影像学检查(计算机断层扫描——CT或/和磁共振成像——MRI)。我们发现7例患者为双侧脑裂畸形,其中2例为单侧;5例患者除脑裂畸形外还发现了其他脑部异常。7例患者存在癫痫发作;其中2例为药物难治性癫痫。尽管有1例患者发育正常,但我们所有患者的发育均延迟。
脑裂畸形是一种严重的脑部畸形,几乎总是导致发育延迟和癫痫。在我们的患者组中,我们未发现异常类型与临床病程、发育延迟程度和癫痫严重程度之间存在相关性。