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Al-Smair A, Younes S, Saadeh O, Saadeh A, Al-Ali A. Adult Presentation of Joubert Syndrome Presenting With Dysphagia: A Case Report. Cureus 2022; 14:e24226. [PMID: 35602833 PMCID: PMC9114833 DOI: 10.7759/cureus.24226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2022] [Indexed: 12/04/2022] Open
Abstract
Joubert syndrome (JS) is a rare autosomal recessive disease affecting the cilium, an intracellular organelle. It has a wide spectrum of presentations with the involvement of multiple genes. JS has multiple subtypes that are either pure JS or JS with other organ involvement such as the kidneys, liver, and others. However, all subtypes share the involvement of the cerebellar peduncles and the brainstem, which presents as "a molar tooth sign" on magnetic resonance imaging, hypotonia, and intellectual disability. It has a higher prevalence among children with few able to survive to adulthood. Unfortunately, survivors live with debilitating comorbidities. Here, we present the case of a 20-year-old patient who presented with a new onset of dysphagia that led to a diagnosis of JS.
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Affiliation(s)
- Ali Al-Smair
- Department of Radiology, Medray International Radiology Center, Amman, JOR
| | - Sara Younes
- Faculty of Medicine, The University of Jordan, Amman, JOR
| | - Osama Saadeh
- Public Health, Northeastern Illinois University, Chicago, USA
| | - Ahmad Saadeh
- Faculty of Medicine, The University of Jordan, Amman, JOR
| | - Ahmad Al-Ali
- Department of Radiology, Jordan Ministry of Health, Amman, JOR
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Romaniello R, Gagliardi C, Desalvo P, Provenzi L, Battini R, Bertini E, Bonati MT, Briguglio M, D'Arrigo S, Dotti MT, Giordano L, Macaluso C, Moroni I, Nuovo S, Santucci M, Signorini S, Stanzial F, Valente EM, Borgatti R. Challenges and resources in adult life with Joubert syndrome: issues from an international classification of functioning (ICF) perspective. Disabil Rehabil 2021; 44:4966-4973. [PMID: 34010585 DOI: 10.1080/09638288.2021.1922516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Joubert Syndrome (JS) is a rare inherited neurodevelopmental disorder defined by a characteristic cerebellar and brainstem malformation (i.e. the molar tooth sign) and variable organ involvement. The aim of the present study was to describe functional limitations and disabilities in a large sample of adult patients with a diagnosis of JS. METHODS We administered the International Classification of Functioning (ICF) checklist to thirty-six adult Italian patients with JS or their caregivers through telephone calls. RESULTS None-to-mild impairment was documented for basic cognitive and mental functions, whereas severe deficit emerged for higher-order skills and language. A mismatch between individuals' capacity for daily activity and social participation and the actual performance in these fields emerged, suggesting that adults with JS may greatly benefit from external support from the caring environment. Indeed, specific facilitators were highlighted, including communication technologies as well as family members, healthcare professionals and peers support. Mild-to-severe barriers have been identified by adult patients with JS in the domains of services, systems and policies. CONCLUSIONS These findings highlight challenges and barriers for adults with JS in areas of daily functioning that may be improved by investing in rehabilitation care models that embed social support programs and policies into clinical interventions.IMPLICATIONS FOR REHABILITATIONChildren with Joubert Syndrome, a child-onset rare inherited neurodevelopmental condition, are growing up and becoming adults; a life course approach in rehabilitation is needed;There is a substantial lack of information on the long-term adaptive daily functioning of children with a diagnosis of Joubert Syndrome;In this paper, the International Classification of Functioning (ICF) was applied to assess the daily functioning in people with JS;Severe deficits emerged for high-order skills and language, whereas the use of communication technologies and the engagement of family members were highlighted as key facilitators;These findings highlight the need for a change of paradigm in the care model of subjects with JS, with the embedding of social support in rehabilitation programs.
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Affiliation(s)
- Romina Romaniello
- Scientific Institute IRCCS E. Medea, Child Neuropsychiatry and Neurorehabilitation Unit, Lecco, Italy
| | - Chiara Gagliardi
- Scientific Institute IRCCS E. Medea, Child Neuropsychiatry and Neurorehabilitation Unit, Lecco, Italy
| | - Patrizia Desalvo
- Scientific Institute IRCCS E. Medea, Child Neuropsychiatry and Neurorehabilitation Unit, Lecco, Italy
| | - Livio Provenzi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Roberta Battini
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Enrico Bertini
- Department of Neuroscience and Neurorehabilitation, Ospedale Pediatrico Bambino Gesù, Roma, Italy
| | - Maria Teresa Bonati
- Clinic of Medical Genetics, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Marilena Briguglio
- Child and Adolescent Neuropsychiatry, University of Messina, Messina, Italy
| | - Stefano D'Arrigo
- Department of Developmental Neurology, Fondazione IRCCS, Istituto Neurologico C. Besta, Milan, Italy
| | - Maria Teresa Dotti
- Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Lucio Giordano
- Child Neuropsychiatric Division, Spedali Civili, Brescia, Italy
| | - Claudio Macaluso
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Isabella Moroni
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Sara Nuovo
- Neurogenetics Unit, IRCCS Fondazione Santa Lucia, Rome.,Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Margherita Santucci
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neuropsichiatria Infantile, Bologna, Italy.,Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italia
| | - Sabrina Signorini
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Franco Stanzial
- Genetic Counseling Service, Department of Pediatrics, Regional Hospital of Bolzano, Bolzano, Italy
| | - Enza Maria Valente
- Department of Molecular Medicine, University of Pavia, Pavia, Italy.,Laboratory of Molecular Medicine and Cytogenetics, IRCCS Mondino Foundation, Pavia, Italy
| | - Renato Borgatti
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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