Yang Wen-Xian, Zhang Hang-Hu, Hu Jia-Ni, Zhao Li, Li Yan-Yun, Shao Xiao-Li
Department of Pediatrics, Shaoxing University School of Medicine, Shaoxing 312000, Zhejiang Province, China.
Department of Pediatrics, Shaoxing Peoples' Hospital, The First Affiliated Hospital of Shaoxing University, Shaoxing 312000, Zhejiang Province, China.
World J Clin Cases. 2021 Oct 16;9(29):8789-8796. doi: 10.12998/wjcc.v9.i29.8789.
gene is a specific gene that encodes actin α2. Multisystem smooth muscle dysfunction syndrome (MSMDS) is a multisystem disease characterized by aortic and cerebrovascular lesions caused by gene mutations. There have been many reports of cardiac, pulmonary and cerebrovascular lesions caused by MSMDS; however, few studies have focused on seizures caused by MSMDS.
Our patient was a girl aged 7 years and 8 mo with recurrent cough, asthma and seizures for 7 years. She was diagnosed with severe pneumonia, congenital heart disease, cardiac insufficiency, and malnutrition in the local hospital. Cardiac ultrasonography revealed congenital heart disease, patent ductus arteriosus (with a diameter of 0.68 cm), left coronary arteriectasis, patent oval foramen (0.12 cm), tricuspid and pulmonary regurgitation, and pulmonary hypertension. Cerebral magnetic resonance imaging and magnetic resonance angiography indicated stiffness in the brain vessels, together with multiple aberrant signaling shadows in bilateral paraventricular regions. A heterozygous mutation (G>A) was identified in the gene, resulting in generation of Finally, the girl was diagnosed with MSMDS combined with epilepsy. The patient had 4 episodes of seizures before treatment, and no onset of seizure was reported after oral administration of sodium valproate for 1 year.
MSMDS has a variety of clinical manifestations and unique cranial imaging features. Cerebrovascular injury and white matter injury may lead to seizures. Gene detection can confirm the diagnosis and prevent missed diagnosis or misdiagnosis.
基因是一种编码肌动蛋白α2的特定基因。多系统平滑肌功能障碍综合征(MSMDS)是一种多系统疾病,其特征是由该基因突变引起的主动脉和脑血管病变。已有许多关于MSMDS导致心脏、肺和脑血管病变的报道;然而,很少有研究关注MSMDS引起的癫痫发作。
我们的患者是一名7岁8个月的女孩,有7年反复咳嗽、哮喘和癫痫发作史。她在当地医院被诊断为重症肺炎、先天性心脏病、心功能不全和营养不良。心脏超声检查显示先天性心脏病、动脉导管未闭(直径0.68 cm)、左冠状动脉扩张、卵圆孔未闭(0.12 cm)、三尖瓣和肺动脉反流以及肺动脉高压。脑磁共振成像和磁共振血管造影显示脑血管僵硬,双侧脑室旁区域有多个异常信号影。在该基因中鉴定出一个杂合突变(G>A),最终,该女孩被诊断为MSMDS合并癫痫。患者在治疗前有4次癫痫发作,口服丙戊酸钠1年后未再出现癫痫发作。
MSMDS有多种临床表现和独特的头颅影像学特征。脑血管损伤和白质损伤可能导致癫痫发作。基因检测可确诊并防止漏诊或误诊。