scholarly journals Ring Chromosome 20 Associated with Refractory Epilepsy: A Case Report

2012 ◽  
Vol 2 (3) ◽  
pp. 141-144
Author(s):  
A Radha Rama Devi ◽  
Usha R Dutta

Ring chromosome 20 is a rare chromosomal abnormality characterized mainly by refractory epileptic seizures, cognitive and behavioral problems, and absence of definite dysmorphic features. We report a 5-year-old boy with refractory epilepsy and minimal dysmorphic features who first presented with mild developmental delay at 11 months of age. The karyotype of the child was 46,XY,r(20)(p13q13.3). Till date there are 69 cases of ring chromosome 20 reported in the literature, including mosaics and supernumerary ring chromosomes. To our knowledge, this is the first case of ring chromosome 20 with refractory epilepsy reported from the south Indian population.DOI: http://dx.doi.org/10.3126/ajms.v2i3.5607Asian Journal of Medical Sciences 2 (2011) 141-144

2017 ◽  
Vol 04 (01) ◽  
pp. 087-089 ◽  
Author(s):  
Umesh Kalane ◽  
Chaitanya Datar ◽  
Shilpa Kalane

AbstractGenetic disorders and chromosomal abnormalities have been shown to represent 2–3% of all cases of epilepsy. Ring chromosome 20 syndrome is a rare chromosomal abnormality and a rare cause of intractable epilepsy. Exact prevalence of ring chromosome 20 is not known. We report a case of a 10-year old boy who had had intractable epilepsy since 2 years of age. Birth history was insignificant and there was no obvious dysmorphism. His motor milestones were normal but cognition and speech were delayed. Electroencephalography showed progressive worsening from initial bi-frontal epileptiform activity to generalized discharges. Neuroimaging and metabolic work up was normal. Karyotype study showed ring chromosome 20. Diagnosis of ring chromosome 20 or r(20) syndrome was made. Ring chromosome 20 syndrome is a rare cause of refractory epilepsy A patient who present with intractable epilepsy with frontal epileptiform discharges, mental developmental delay, without dysmorphic features should be suspected of chromosomal abnormalities especially ring chromosome 20.


2017 ◽  
Vol 11 (1) ◽  
pp. 8-16
Author(s):  
Alice Shelton ◽  
Samuel Joseph Tromans ◽  
Sabyasachi Bhaumik ◽  
Reza Kiani

Purpose The purpose of this paper is to discuss the challenges of assessment and management of psychotic symptoms in a background of intellectual disability (ID) and treatment-resistant epilepsy caused by a genetic syndrome. Design/methodology/approach Ring chromosome 20 [r(20)] syndrome is characterised by the triad of severe refractory epilepsy, mild to severe ID and behavioural problems. This paper describes the presentation of r(20) syndrome in a young woman with moderate ID and treatment-resistant epilepsy, who experiences psychotic symptoms at times of improved seizure control. Findings There are several diagnostic possibilities for such a presentation, including psychotic symptoms due to adverse effects of anti-epileptic medications and forced normalisation (alternating psychosis). Originality/value This paper advocates judicious use of antipsychotic medication to manage psychotic symptoms, as well as involvement of both patient and close family members throughout all stages of care. It is essential to strike a balance between control of epileptic seizures and psychiatric symptoms, providing an optimal benefit to the patients’ quality of life by meeting their complex needs through a multidisciplinary and multi-agency team input.


Author(s):  
Н.В. Шилова ◽  
М.Е. Миньженкова ◽  
Ж.Г. Маркова ◽  
А.А. Тарлычева ◽  
Д.А. Юрченко

Актуальность. Кольцевая хромосома 3 - редкая хромосомная аномалия, характеризующаяся выраженной вариабельностью фенотипических отклонений. Наиболее характерными проявлениями присутствия в кариотипе кольцевой хромосомы 3 являются пре- и постнатальная задержка роста, задержка психомоторного развития, микроцефалия и другие аномалии развития. Кольцевая структура может приводить к нарушению нормального расхождения хромосом при клеточном делении и вызывает митотическую нестабильность, приводящую к динамическому мозаицизму. В данном сообщении представлен случай митотической нестабильности кольцевой хромосомы 3 у ребенка с множественными пороками и аномалиями развития, демонстрирующий влияние вторичного хромосомного дисбаланса на степень выраженности фенотипических аномалий. Цель: исследование митотической нестабильности кольцевой хромосомы 3. Методы: FISH с ДНК-зондами на хромосому 3. Результаты. При стандартном цитогенетическом исследовании определен кариотип 46,XX,r(3)(p26q29). При FISH-анализе обнаружено наличие нескольких клонов клеток, содержащих различные варианты аномальных по структуре производных кольцевой хромосомы 3. Выводы. Присутствие кольцевых хромосом в геноме является причиной митотической нестабильности, что приводит к формированию соматического динамического мозаицизма. Соматический динамический мозаицизм, вследствие которого образуются клоны клеток с различным хромосомным дисбалансом, вносит существенный вклад в формирование аномального фенотипа. Ring chromosome 3 is a rare chromosomal abnormality with a highly variable phenotype principally characterized by pre- and postnatal growth retardation, developmental delay, mild to severe intellectual disability, microcephaly and mild dysmorphic features. The presence of a ring chromosome causes mitotic instability and often results in dynamic mosaicism with cells showing chromosomal or segmental aneuploidies and leading to various phenotypic consequences. We present a case of mitotic instability of ring chromosome 3 in a child with multiple malformations and developmental abnormalities. Aim: The investigation of ring chromosome 3 instability at mitosis. Methods: FISH with DNA probe on chromosome 3. Results: The karyotype of a child - 46,XX,r(3)(p26q29). FISH analysis revealed a mosaic clones derived from ring chromosome 3. Conclusions: The ring chromosomes are unstable at mitosis and lead to the formation of somatic dynamic mosaicism. Mitotic instability of ring chromosome 3 demonstrates the influence of secondary genetic imbalance on severity of symptoms in our patient.


2017 ◽  
Vol 48 (S 01) ◽  
pp. S1-S45
Author(s):  
A. Herting ◽  
T. Cloppenborg ◽  
A. Hofmann-Peters ◽  
T. Polster

Epilepsia ◽  
2014 ◽  
Vol 55 (3) ◽  
pp. 403-413 ◽  
Author(s):  
Anna Elisabetta Vaudano ◽  
Andrea Ruggieri ◽  
Aglaia Vignoli ◽  
Pietro Avanzini ◽  
Francesca Benuzzi ◽  
...  

2016 ◽  
Vol 74 (12) ◽  
pp. 1031-1034
Author(s):  
Vera Cristina Terra ◽  
Isabella D’Andrea-Meira ◽  
Ricardo Amorim ◽  
Francisco Arruda ◽  
Andrea Julião de Oliveira ◽  
...  

ABSTRACT Epilepsy is a potentially devastating brain disorder characterized by a predisposition to spontaneous epileptic seizures. In patients with medically refractory epilepsy, new non-pharmacological therapeutic approaches may be considered. In this scenario, palliative surgery such as vagus nerve stimulation (VNS) or deep brain stimulation (DBS) may be indicated in a subset of patients. In this paper we make recommendations for the use of VNS and DBS in patients in Brazil with refractory epilepsy.


2007 ◽  
Vol 47 (5) ◽  
pp. 343-346
Author(s):  
Asude Alpman ◽  
Gul Serdaroglu ◽  
Ozgur Cogulu ◽  
Hasan Tekgul ◽  
Sarenur Gokben ◽  
...  

Epilepsia ◽  
2006 ◽  
Vol 47 (3) ◽  
pp. 543-549 ◽  
Author(s):  
Dorothee Ville ◽  
Anna Kaminska ◽  
Nadia Bahi-Buisson ◽  
Arnaud Biraben ◽  
Perrine Plouin ◽  
...  

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