Gagan Devesh, Kumar Sudesh, Bhattacharya Piyali, Kaur Simranjit
MGM Medical College, Kishanganj, Bihar, India.
Glob Pediatr Health. 2023 Mar 1;10:2333794X231157979. doi: 10.1177/2333794X231157979. eCollection 2023.
Pelizaeus-Merzbacher disease, a rare X-linked recessive disease occurring predominantly in males, is a disorder of proteolipid protein expression in myelin formation in the central nervous system. The disease is clinically manifested by neurodevelopmental delay, ataxia, hypotonia, and pendular eye movement. It is best confirmed by genetic study. A 4-year female child presented with ataxia, neuroregression, decreased scholastic performance, slurred speech, loss of bladder and bowel control, and hypotonia. MRI brain showed generalized hypomyelination and atrophy of the cerebrum and cerebellum. This case highlights that Pelizaeus-Merzbacher disease can be considered even in a female child who presented with neurodevelopmental delay and neuro regression, ataxia, and decreased scholastic performance and further confirmed by MRI showing diffuse demyelination along with cerebral and cerebellar atrophy.
佩利措伊斯-梅茨巴赫病是一种罕见的X连锁隐性疾病,主要发生于男性,是中枢神经系统髓鞘形成过程中蛋白脂蛋白表达紊乱所致。该病临床表现为神经发育迟缓、共济失调、肌张力减退和眼球钟摆样运动。通过基因研究可得到最佳确诊。一名4岁女童出现共济失调、神经功能倒退、学业成绩下降、言语含糊、大小便失禁和肌张力减退。脑部MRI显示大脑和小脑普遍髓鞘形成不良及萎缩。该病例表明,对于出现神经发育迟缓、神经功能倒退、共济失调及学业成绩下降的女童,即使是女童,也应考虑佩利措伊斯-梅茨巴赫病,MRI显示弥漫性脱髓鞘伴大脑和小脑萎缩可进一步确诊。