Moreno Izco F, Zuazo Zamalloa E, González Alvaredo S, Bereciartu Irastorza P
Unidad de Neurologia, Hospital Zumárraga, Zumárraga.
Neurologia. 2009 Jan-Feb;24(1):69-71.
Chromosome 22q11 deletion syndrome is a syndromic complex which includes several manifestations such as cardiac defects, immunodeficiency, cleft palate and facial dysmorphic features. It is also associated with developmental delay and other neuropsychiatric symptoms. Epilepsy is an uncommon manifestation.
A 15 year old female patient with a history of developmental delay and learning difficulties. She began with generalized and partial complex epileptic seizures of unknown etiology in the absence of other known risk factors for seizures. Brain magnetic resonance imaging and electroencephalographic recording were normal. Neuropsychiatric history, phenotype with nasal voice and dysmorphic features justified the study of the 22q11 deletion that was diagnostic.
22q11 deletion is one of the most common microdeletion chromosomal syndromes. In recent years more atypical cases are being diagnosed due to a better knowledge of the syndrome and the availability of the fluorescence in situ hybridization test. These cases are conferring a wider phenotypical spectrum to the syndrome.Therefore, increasing awareness of the expression of this syndrome by different specialists is essential. Clinical features such as facial dysmorphism or nasal speech in atypical cases are important diagnostic clues.
22q11 缺失综合征是一种综合征复合体,包括心脏缺陷、免疫缺陷、腭裂和面部畸形等多种表现。它还与发育迟缓及其他神经精神症状有关。癫痫是一种不常见的表现。
一名 15 岁女性患者,有发育迟缓和学习困难病史。在没有其他已知癫痫风险因素的情况下,她开始出现病因不明的全身性和部分复杂性癫痫发作。脑磁共振成像和脑电图记录均正常。神经精神病史、带有鼻音的表型和畸形特征促使对 22q11 缺失进行研究,结果确诊。
22q11 缺失是最常见的微缺失染色体综合征之一。近年来,由于对该综合征的认识提高以及荧光原位杂交检测的应用,越来越多的非典型病例被诊断出来。这些病例使该综合征的表型谱更广。因此,提高不同专科医生对该综合征表现的认识至关重要。非典型病例中的面部畸形或鼻音等临床特征是重要的诊断线索。