Rivas Lucía, Blanco Óscar, Torreira Cristina, Repáraz Alfredo, Melcón Cristina, Amado Alfonso
Departamento de Pediatría, Complexo Hospitalario Universitario de Pontevedra, España.
Sección de Neuropediatría, Servicio de Pediatría, Complexo Hospitalario Universitario de Vigo, España.
Rev Chil Pediatr. 2017;88(4):529-533. doi: 10.4067/S0370-41062017000400014.
Pontocerebellar hypoplasia (PCH) is a reduction of the size of the cerebellum and pons secondary to an alteration in its development, and can be caused by neurodegenerative diseases of genetic origin, of which there are known 10 subtypes (PCH 1-10), cortical malformations, metabolic and genetic diseases.
To present the case of a child with microcephaly, PCH and West syndrome, in which the genetic study allowed to make the diagnosis of a deletion on chromosome X.
This is a female infant of 7-month at diagnosis, without family or obstetric history of interest, head circumference at birth -1.5 standard deviations (SD). She had little weight and growth in head circumference progression. In addition, physical examination revealed no fixating gaze, hypotonia with preserved deep tendon reflexes. Progressively developed refractary seizures. Brainsteam Auditory Evoked Potential demonstrated involvement of pontomesencefphalic ways and neuroimaging Pontocerebellar hypoplasia. The genetic study (aCGH) showed heterozygous deletion on the X chromosome, affecting the CASK gene.
Given the wide differential diagnosis proposed at the PCH, new cytogenetic techniques have improved the classification of HPC and in some cases establish their etiology, so in these cases can provide appropriate genetic counseling to families.
脑桥小脑发育不全(PCH)是小脑和脑桥体积减小,继发于其发育改变,可由遗传起源的神经退行性疾病引起,已知有10种亚型(PCH 1 - 10),还可由皮质畸形、代谢和遗传疾病引起。
介绍一例患有小头畸形、PCH和韦斯特综合征的儿童病例,其中基因研究有助于诊断X染色体缺失。
这是一名诊断时7个月大的女婴,无相关家族史或产科病史,出生时头围低于1.5个标准差(SD)。她体重轻,头围增长缓慢。此外,体格检查未发现凝视固定,肌张力减退但深腱反射保留。逐渐出现难治性癫痫发作。脑干听觉诱发电位显示脑桥中脑通路受累,神经影像学检查显示脑桥小脑发育不全。基因研究(aCGH)显示X染色体杂合缺失,影响CASK基因。
鉴于PCH的鉴别诊断范围广泛,新的细胞遗传学技术改善了HPC的分类,在某些情况下确定了其病因,因此在这些病例中可为家庭提供适当的遗传咨询。