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Norman-Roberts syndrome(LIS2)

MedGen UID:
163213
Concept ID:
C0796089
Disease or Syndrome
Synonyms: LIS2; Lissencephaly 2; Lissencephaly 2 (Norman-Roberts type); Lissencephaly syndrome Norman-Roberts type
SNOMED CT: Lissencephaly syndrome Norman Roberts type (717977003); Microlissencephaly type A (717977003)
Modes of inheritance:
Autosomal recessive inheritance
MedGen UID:
141025
Concept ID:
C0441748
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in individuals with two pathogenic alleles, either homozygotes (two copies of the same mutant allele) or compound heterozygotes (whereby each copy of a gene has a distinct mutant allele).
 
Gene (location): RELN (7q22.1)
 
Monarch Initiative: MONDO:0009760
OMIM®: 257320
Orphanet: ORPHA89844

Definition

Lissencephaly with cerebellar hypoplasia (LCH) affects brain development, resulting in the brain having a smooth appearance (lissencephaly) instead of its normal folds and grooves. In addition, the part of the brain that coordinates movement is unusually small and underdeveloped (cerebellar hypoplasia). Other parts of the brain are also often underdeveloped in LCH, including the hippocampus, which plays a role in learning and memory, and the part of the brain that is connected to the spinal cord (the brainstem).

Individuals with LCH have moderate to severe intellectual disability and delayed development. They have few or no communication skills, extremely poor muscle tone (hypotonia), problems with coordination and balance (ataxia), and difficulty sitting or standing without support. Most affected children experience recurrent seizures (epilepsy) that begin within the first months of life. Some affected individuals have nearsightedness (myopia), involuntary eye movements (nystagmus), or puffiness or swelling caused by a buildup of fluids in the body's tissues (lymphedema). [from MedlinePlus Genetics]

Clinical features

From HPO
Generalized-onset seizure
MedGen UID:
115963
Concept ID:
C0234533
Disease or Syndrome
A generalized-onset seizure is a type of seizure originating at some point within, and rapidly engaging, bilaterally distributed networks. The networks may include cortical and subcortical structures but not necessarily the entire cortex.
Lissencephaly
MedGen UID:
78604
Concept ID:
C0266463
Finding
A spectrum of malformations of cortical development caused by insufficient neuronal migration that subsumes the terms agyria, pachygyria and subcortical band heterotopia. See also neuropathological definitions for 2-, 3-, and 4-layered lissencephaly.
Cerebellar hypoplasia
MedGen UID:
120578
Concept ID:
C0266470
Congenital Abnormality
Cerebellar hypoplasia is a descriptive term implying a cerebellum with a reduced volume, but a normal shape and is stable over time.
Classic lissencephaly
MedGen UID:
98463
Concept ID:
C0431375
Disease or Syndrome
Isolated lissencephaly sequence (ILS) is a condition that affects brain development before birth. Normally, the cells that make up the exterior of the brain (cerebral cortex) are well-organized, multi-layered, and arranged into many folds and grooves (gyri). In people with ILS, the cells of the cerebral cortex are disorganized, and the brain surface is abnormally smooth with an absence (agyria) or reduction (pachygyria) of folds and grooves. In most cases, these abnormalities impair brain growth, causing the brain to be smaller than normal (microcephaly). This underdevelopment of the brain causes severe intellectual disability, delayed development, and recurrent seizures (epilepsy) in individuals with ILS.\n\nMore than 90 percent of individuals with ILS develop epilepsy, often within the first year of life. Up to 80 percent of infants with ILS have a type of seizure called infantile spasms, these seizures can be severe enough to cause brain dysfunction (epileptic encephalopathy). After the first months of life, most children with ILS develop a variety of seizure types, including persisting infantile spasms, short periods of loss of consciousness (absence seizures); sudden episodes of weak muscle tone (drop attacks); rapid, uncontrolled muscle jerks (myoclonic seizures); and episodes of muscle rigidity, convulsions, and loss of consciousness (tonic-clonic seizures).\n\nInfants with ILS may have poor muscle tone (hypotonia) and difficulty feeding, which leads to poor growth overall. Hypotonia also affects the muscles used for breathing, which often causes breathing problems that can lead to a life-threatening bacterial lung infection known as aspiration pneumonia. Children with ILS often develop muscle stiffness (spasticity) in their arms and legs and an abnormal side-to-side curvature of the spine (scoliosis). Rarely, the muscle stiffness will progress to paralysis (spastic paraplegia). Individuals with ILS cannot walk and rarely crawl. Most children with ILS do not develop communication skills.
Global developmental delay
MedGen UID:
107838
Concept ID:
C0557874
Finding
A delay in the achievement of motor or mental milestones in the domains of development of a child, including motor skills, speech and language, cognitive skills, and social and emotional skills. This term should only be used to describe children younger than five years of age.
Hypoplasia of the pons
MedGen UID:
341246
Concept ID:
C1848529
Finding
Underdevelopment of the pons.
Thick cerebral cortex
MedGen UID:
870522
Concept ID:
C4024970
Anatomical Abnormality
Hypotonia
MedGen UID:
10133
Concept ID:
C0026827
Finding
Hypotonia is an abnormally low muscle tone (the amount of tension or resistance to movement in a muscle). Even when relaxed, muscles have a continuous and passive partial contraction which provides some resistance to passive stretching. Hypotonia thus manifests as diminished resistance to passive stretching. Hypotonia is not the same as muscle weakness, although the two conditions can co-exist.
Microcephaly
MedGen UID:
1644158
Concept ID:
C4551563
Finding
Head circumference below 2 standard deviations below the mean for age and gender.
Lymphedema
MedGen UID:
6155
Concept ID:
C0024236
Pathologic Function
Localized fluid retention and tissue swelling caused by a compromised lymphatic system.
Prominent nasal bridge
MedGen UID:
343051
Concept ID:
C1854113
Finding
Anterior positioning of the nasal root in comparison to the usual positioning for age.
Sloping forehead
MedGen UID:
346640
Concept ID:
C1857679
Finding
Inclination of the anterior surface of the forehead from the vertical more than two standard deviations above the mean (objective); or apparently excessive posterior sloping of the forehead in a lateral view.

Recent clinical studies

Etiology

Natacci F, Bedeschi MF, Righini A, Inverardi F, Rizzuti T, Boschetto C, Triulzi F, Spreafico R, Frassoni C, Lalatta F
Prenat Diagn 2007 Jun;27(6):568-72. doi: 10.1002/pd.1728. PMID: 17367103
Dobyns WB, Stratton RF, Greenberg F
Am J Med Genet 1984 Jul;18(3):509-26. doi: 10.1002/ajmg.1320180320. PMID: 6476009

Diagnosis

Tosello B, Brévaut-Malaty V, Chaumoître K, Gire C
Fetal Pediatr Pathol 2015 Jun;34(3):197-201. Epub 2015 Apr 30 doi: 10.3109/15513815.2015.1031414. PMID: 25927602
Natacci F, Bedeschi MF, Righini A, Inverardi F, Rizzuti T, Boschetto C, Triulzi F, Spreafico R, Frassoni C, Lalatta F
Prenat Diagn 2007 Jun;27(6):568-72. doi: 10.1002/pd.1728. PMID: 17367103
Caksen H, Tuncer O, Kirimi E, Fryns JP, Uner A, Unal O, Cinal A, Odabaş D
Genet Couns 2004;15(1):9-17. PMID: 15083694
Sergi C, Zoubaa S, Schiesser M
Prenat Diagn 2000 Jun;20(6):505-9. PMID: 10861718
Iannetti P, Schwartz CE, Dietz-Band J, Light E, Timmerman J, Chessa L
Am J Med Genet 1993 Aug 1;47(1):95-9. doi: 10.1002/ajmg.1320470120. PMID: 8368261

Prognosis

Dobyns WB, Stratton RF, Greenberg F
Am J Med Genet 1984 Jul;18(3):509-26. doi: 10.1002/ajmg.1320180320. PMID: 6476009

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