Arriola-Pereda G, Verdú-Pérez A, de Castro-De Castro P
Sección de Neurología Infantil, Hospital General Universitario Gregorio Marañón, Madrid, España.
Rev Neurol. 2009;48(4):188-90.
Chromosome 22q11 microdeletion syndrome, DiGeorge syndrome or CATCH 22 spectrum, is characterised by conotruncal heart malformations, facial dysmorphisms, cleft palate, velopharyngeal insufficiency, transient hypocalcemia and T cell disorders. Furthermore, a significant number of patients may present autism-type developmental disorders, learning disabilities, attention deficit hyperactivity disorder or schizophrenia-like psychiatric problems.
A girl with congenital heart disease that had been treated surgically in the neonatal period, who presented psychomotor retardation, dysmorphic features and microcephaly. The conventional karyotype study that was performed at birth was normal. The physical examination revealed subtle signs of left hemiparesis. A neuroimaging study showed polymicrogyria-type cortical dysplasia that involved the right frontotemporal cortex. A chromosomal study was conducted and findings showed a 22q11.2 chromosome deletion.
Brain malformations in children with deletion of the 22q11.2 chromosome have been reported previously, but their real prevalence and the most frequent type of malformation have not been properly determined. The authors conclude that brain malformations should be studied in all patients with 22q11.2 deletion and it should be borne in mind that all patients with cortical dysplasias may present this deletion.
22q11微缺失综合征,又称迪格奥尔格综合征或CATCH 22谱系,其特征为圆锥动脉干心脏畸形、面部畸形、腭裂、腭咽闭合不全、短暂性低钙血症和T细胞紊乱。此外,相当数量的患者可能出现自闭症谱系发育障碍、学习障碍、注意力缺陷多动障碍或精神分裂症样精神问题。
一名患有先天性心脏病的女孩,在新生儿期接受了手术治疗,出现精神运动发育迟缓、畸形特征和小头畸形。出生时进行的常规核型研究正常。体格检查发现左侧偏瘫的细微体征。神经影像学研究显示右侧额颞叶皮质存在多小脑回型皮质发育异常。进行了染色体研究,结果显示22q11.2染色体缺失。
先前已有关于22q11.2染色体缺失儿童脑畸形的报道,但它们的实际患病率和最常见的畸形类型尚未得到确切确定。作者得出结论,应对所有22q11.2缺失患者进行脑畸形研究,并且应牢记所有皮质发育异常患者可能存在这种缺失。