A patient with septo-optic dysplasia plus

Six adult patients with septo-optic dysplasia and drug-resistant epilepsy: Clinical findings and course

Septo-optic dysplasia (SOD) is a rare disorder associated with optic nerve hypoplasia, pituitary abnormalities and agenesis/dysgenesis of midline brain structures including the septum pellucidum and corpus callosum. Though sometimes associated with drug-resistant epilepsy, this association has not been well studied. We report six SOD patients with associated malformation of cortical development (MCD) and drug-resistant epilepsy who underwent video-EEG telemetry at our centre between 1998 and 2016 for drug-resistant epilepsy. ‬Three then underwent surgery; right temporal neocortical resection, right functional hemispherectomy and placement of a vagus nerve stimulator. Clinical findings and the patients' ultimate courses are discussed.

Septo-optic dysplasia in childhood: the neurological, cognitive and neuro-ophthalmological perspective

AIM

We set out to describe 17 patients with septo-optic dysplasia (SOD), focusing on the little-explored neurological, cognitive, and neuro-ophthalmological components. A further aim was to identify possible clinical correlations and phenotypic characteristics within the diagnostic spectrum.

METHOD

We collected clinical-instrumental data (from the history, general and neurological examination, developmental assessment, and neuro-ophthalmological, neuroradiological, neurophysiological, and endocrinological evaluations) on nine males and eight females (mean age 34.4mo, SD 31.6; range 4mo-9y 6mo) diagnosed with SOD who were referred to our Centre of Child Neuro-ophthalmology between 1999 and 2010.

RESULTS

We observed a heterogeneous clinical spectrum characterized by nervous system, visual, and endocrine dysfunctions; optic nerve involvement was present in all 17 children, midline brain defects in 14, and cortical developmental malformations in seven. Developmental/cognitive delay and relational and communication difficulties were observed in eight and seven children, respectively, and reduced visual acuity and oculomotor dysfunction were observed in all. Pituitary hormone deficiencies were present in nine children.

INTERPRETATION

Nervous system involvement emerged as a key feature of SOD. As part of a holistic approach to the disease, particular attention should be paid to this aspect. The emergence of new clinical correlations and correlations between clinical features and three SOD subtypes opens the way for better clarification of this disease and, therefore, more targeted diagnosis, follow-up, and care of affected children.

[Septo-optic dysplasia (De Morsier's syndrome). About one case discovered during the pregnancy]

The authors report a case of septo-optic dysplasia discovered during the pregnancy without another abnormality. It's a rare cerebral abnormality that is characterized by an absence of septum pellucidum associated to a hypoplasia of ways and optic chiasm to variable degrees. Discovery is often made for adulthood. Future is extremely wide. It is determined with the arisen to different degrees of incapacity of Pituitary gland, psychomotor delay of variable intensity with mental deficiency, a visual confusion, and a confusion of the regulation of the temperature.

Septo-optic dysplasia plus: a patient with diabetes insipidus

The association of septo-optic dysplasia and cortical dysplasia is described as septo-optic dysplasia-plus. Reports on patients with septo-optic dysplasia-plus have been rare. We describe a 4-year-old girl with septo-optic dysplasia-plus syndrome, characterized by septo-optic dysplasia with schizencephaly, pachygyria, and diabetes insipidus.

Two cases of septo-optic dysplasia-plus syndrome with epilepsy and mirror hand movements

Septo-optic dysplasia (SOD) is a rare developmental anomaly first described by Reeves. It is a heterogeneous condition defined loosely by any combination of optic nerve hypoplasia, pituitary hypoplasia, and midline neuroradiological malformations. The etiology of SOD remains unclear. SOD-plus is the association of SOD and disorders of neuronal organization. Herein we describe two patients with SOD-plus syndrome characterized by SOD with epilepsy and multiple skeletal and central nervous system abnormalities. These two cases indicate that SOD results from disorders in multiple developmental stages. In addition, this is the first report of SOD-plus syndrome with mirror hand movements. Advances in neuroradiological evaluation techniques enable the detection of associated central nervous system abnormalities that can be special characteristics for the diagnosis of the spectrum of SOD-plus.