Review of cases presenting with microcephaly and bilateral congenital cataract in a paediatric cataract clinic

Neuropathological Findings in a Case of Parkinsonism and Developmental Delay Associated with a Monoallelic Variant in PLXNA1

BACKGROUND

PLXNA1 encodes for Plexin-A, a transmembrane protein expressed in the developing nervous system. Mutations in this gene have been associated with developmental delay but have not been previously associated with the development of parkinsonism.

OBJECTIVES

To describe the case of a 38-year-old patient with developmental delay who developed parkinsonism later in life.

METHODS

Post-mortem exome sequencing was performed with confirmation by Sanger sequencing. Brain autopsy was also performed.

RESULTS

Post-mortem exome sequencing on the proband identified a heterozygous predicted nonsense PLXNA1 variant (c.G3361T:p.Glu1121Ter). Pathology demonstrated arhinencephaly with brainstem heterotopia, diffuse Lewy body disease, and frontotemporal lobar dementia-tau.

CONCLUSIONS

This case of a patient with developmental delay and parkinsonism with PLXNA1 mutation highlights a need for assessing long-term outcomes of individuals with neurodevelopmental disorders, as well as the need for genetic testing in adults. It also suggests that the link between PLXNA1 and α-synuclein should be explored in the future. © 2021 International Parkinson and Movement Disorder Society.

Diagnosis, Early Care, and Treatment of Hallermann-Streiff Syndrome: A Review of the Literature

Hallermann-Streiff syndrome is a rare congenital disorder characterized by a wide spectrum of craniofacial abnormalities. A review of the available literature reveals that only approximately 200 cases of the disease have been reported worldwide. For this article, we performed a literature review as a basis for a proposed scheme for early care and treatment. A comprehensive database search was carried out with the use of Medline (PubMed), ISI Web of Science, and ScienceDirect/Scopus. Of the 551 studies initially found, an evaluation using inclusion and exclusion criteria ultimately resulted in a total of 33 articles. Most of the articles are case reports, and only approximately 20% of these articles include treatment options. We propose an early care and treatment schedule based on the presented symptoms. [Pediatr Ann. 2021;50(5):e227-e231.].

Eye involvement in inherited metabolic disorders

Inherited metabolic disorders are a large group of rare disorders affecting normal biochemical pathways. Many metabolic disorders can present with symptoms affecting the eye, and eye disorders can evolve later in the natural history of an already diagnosed metabolic disorder. The ophthalmic involvement can be very varied affecting any part of the eye, including abnormalities of cornea, lens dislocation and cataracts, retina and the distal optic pathway, and extraocular muscles. Awareness of inherited metabolic disorders is important to facilitate early diagnosis and in some cases instigate early treatment if a patient presents with eye involvement suggestive of a metabolic disorder. Ophthalmological interventions are also an important component of the multisystem holistic approach to treating patients with metabolic disorders.

Ocular effects of Zika virus-a review

Zika virus was considered an innocent pathogen while restricted to the African and Asian population; however, after reaching the Americas in March 2015, it became a global threat. Despite usually causing mild or no symptoms in infected adults, Zika virus displays a different behavior toward fetuses. When infected during gestation, fetuses have their immature neural cells killed by the virus and consequently have devastating findings at birth. In the past year the drastic effects of Zika virus infection in newborns include neurological, ophthalmological, audiological, and skeletal abnormalities. These findings represent a new entity called congenital Zika syndrome. We summarize the ocular findings of congenital Zika Syndrome, as well as the current understanding of the illness, systemic manifestations, laboratory investigation, differential diagnosis, prophylaxis, and treatment for this disorder.

Neuropädiatrische Differenzialdiagnostik der Mikrozephalie im Kindesalter

Eine Mikrozephalie betrifft 2–3 % der Bevölkerung und geht oftmals mit einer Intelligenzminderung einher. Die zugrunde liegende Reduktion des Gehirnvolumens kann sowohl durch exogene Faktoren als auch durch genetische Ursachen bedingt sein. Problematisch sind sowohl die uneinheitliche Klassifikation als auch die große Heterogenität der hinter dem klinischen Zeichen Mikrozephalie stehenden Erkrankungen. Im vorliegenden Artikel stellen wir unseren Vorschlag für die diagnostische Herangehensweise an ein Kind mit Mikrozephalie aus neuropädiatrischer Sicht vor.