ETIOLOGY, DIAGNOSIS, AND MANAGEMENT OF CHILDHOOD MICROCEPHALY: A SINGLE-CENTER RETROSPECTIVE STUDY

D. Güven, D. Ardıçlı, D. Sarıcı
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Abstract

Background: Microcephaly is a condition that causes a reduction in brain volume as well as cognitive and motor impairments. It can be seen alone or in conjunction with a variety of genetic disorders and environmental factors. Microcephaly is still a poorly defined condition, identifying the etiological causes is critical for providing genetic counseling, and preventing potential consequences. Objective: The aim of this study was to assess the etiology, diagnosis, and management of the childhood microcephaly. Methods: We conducted a retrospective analysis on 50 children with microcephaly (25 males, 25 females) who presented to University of Health Sciences, Ankara Keçiören Training and Research Hospital between 2017-2021.The demographic features of the patients, neuroimaging, clinical and laboratory findings were examined. Results: The etiology of microcephaly was documented in 76% of all patients. Genetic causes were identified in 16 % of the patients; including Aicardi Goutieres Syndrome,Williams Syndrome , Wolfram Syndrome, Rett Syndrome and Asparagine Synthetase Deficiency. Syndactyly, scoliosis, Poland syndrome, dysmorphic face, alopecia, auricular ear deformities, hearing loss, strabismus, nystagmus, hydronephrosis, single umbilical artery, and cardiac septal defect were detected systemic malformations associated with microcephaly. In sixty percent of the patients, a neuroimaging was performed; results were abnormal in 24% of the patients. The mean follow-up period of the patients was 1.88± 0.6 years. Cognitive impairment was associated with microcephaly in 38% of the cases, and epilepsy in 20%. Of those 28% of the children required special education. One patient was operated by neurosurgeon due to craniosynostosis. Conclusion: Microcephaly is still a poorly defined condition, identifying the etiological causes is critical for providing genetic counseling, and preventing potential consequences.
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儿童小头畸形的病因、诊断和治疗:一项单中心回顾性研究
背景:小头症是一种导致脑容量减少以及认知和运动障碍的疾病。它可以单独出现,也可以与各种遗传疾病和环境因素一起出现。小头畸形仍然是一种定义不明确的疾病,确定病因对于提供遗传咨询和预防潜在后果至关重要。目的:本研究的目的是评估儿童小头畸形的病因、诊断和治疗。方法:回顾性分析2017-2021年间在安卡拉健康科学大学Keçiören培训与研究医院就诊的50例小头畸形儿童(男25例,女25例)。检查了患者的人口统计学特征、神经影像学、临床和实验室结果。结果:76%的患者有小头症的病因。16%的患者被确定为遗传原因;包括Aicardi Goutieres综合征、Williams综合征、Wolfram综合征、Rett综合征和天冬酰胺合成酶缺乏症。并指畸形、脊柱侧凸、波兰综合征、面部畸形、脱发、耳廓畸形、听力丧失、斜视、眼球震颤、肾积水、单一脐动脉和心隔缺损均被发现与小头畸形相关的系统性畸形。在60%的患者中,进行了神经成像;24%的患者结果异常。患者平均随访时间为1.88±0.6年。38%的认知障碍与小头畸形有关,20%与癫痫有关。其中28%的孩子需要特殊教育。1例患者因颅缝闭锁经神经外科手术治疗。结论:小头畸形仍是一种不明确的疾病,确定病因对提供遗传咨询和预防潜在后果至关重要。
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