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Matera E, Petruzzelli MG, Tarantini M, Gabellone A, Marzulli L, Ficarella R, Orsini P, Margari L. Horizontal Gaze Palsy with Progressive Scoliosis with Overlapping Epilepsy and Learning Difficulties: A Case Report. Brain Sci 2022; 12:brainsci12050613. [PMID: 35625000 PMCID: PMC9139940 DOI: 10.3390/brainsci12050613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/27/2022] [Accepted: 05/07/2022] [Indexed: 12/10/2022] Open
Abstract
Horizontal gaze palsy with progressive scoliosis (HGPPS) is a rare congenital disease characterized by the absence of horizontal gaze movements, progressive scoliosis, and typical brain, cerebellum, and medullary malformations. Here we describe a pediatric HGPPS case with overlapping epilepsy and learning difficulties. A 6-year-old girl was admitted to the University Hospital of Bari for the onset of a tonic–clonic seizure. Electroencephalogram showed slow and sharp waves on the right side with the tendency to diffuse. Brain magnetic resonance imaging demonstrated malformations compatible with HGPPS. Ophthalmological and orthopedic evaluations confirmed conjugate horizontal gaze palsy and mild thoracolumbar scoliosis. Neuropsychological assessment attested normal intelligence but serious difficulties in reading and writing. In spite of neuroradiological malformations, visual difficulties, and spinal deformities, literature data are limited about any coexisting neurocognitive HGPPS symptoms. Literature data regarding such topics are very limited. If, on the one hand, the coexistence of such symptoms can be interpreted as occasional, it could support the idea that they could fall within a spectrum of HGPPS anomalies. In addition to the standard investigations, the activation of specific neuropsychological assessment programs could help interventions improve the specialist care and the quality of life of HGPPS patients.
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Affiliation(s)
- Emilia Matera
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (E.M.); (M.T.); (A.G.); (L.M.); (L.M.)
| | - Maria Giuseppina Petruzzelli
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy
- Correspondence:
| | - Martina Tarantini
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (E.M.); (M.T.); (A.G.); (L.M.); (L.M.)
| | - Alessandra Gabellone
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (E.M.); (M.T.); (A.G.); (L.M.); (L.M.)
| | - Lucia Marzulli
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (E.M.); (M.T.); (A.G.); (L.M.); (L.M.)
| | - Romina Ficarella
- Medical Genetics Unit, Department of Human Reproductive Medicine, ASL Bari, Via Ospedale Di Venere 1, 70012 Bari, Italy; (R.F.); (P.O.)
| | - Paola Orsini
- Medical Genetics Unit, Department of Human Reproductive Medicine, ASL Bari, Via Ospedale Di Venere 1, 70012 Bari, Italy; (R.F.); (P.O.)
| | - Lucia Margari
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (E.M.); (M.T.); (A.G.); (L.M.); (L.M.)
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Deniz A, Çomu S, Güngör M, Anık Y, Kara B. Compound Heterozygous ROBO3 Mutation in Two Siblings Presenting with Horizontal Gaze Palsy without Scoliosis: Case-Based Review. J Pediatr Genet 2021. [DOI: 10.1055/s-0041-1739387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AbstractHorizontal gaze palsy with progressive scoliosis (HGPPS) is a rare, autosomal recessively inherited disorder characterized by a congenital absence of conjugated horizontal eye movements with progressive scoliosis developing in childhood and adolescence. HGPPS is caused by mutations of the ROBO3 gene that disrupts the midline crossing of the descending corticospinal and ascending lemniscal sensory tracts in the medulla. We present two siblings, 5-year-old and 2-year-old boys with HGPPS, from non-consanguineous parents. The older brother was brought for the evaluation of moderate psychomotor retardation. He had bilateral horizontal gaze palsy with preserved vertical gaze and convergence. Scoliosis was absent. Cranial MRI showed brainstem abnormalities, and diffusion tensor imaging showed absent decussation of cortico-spinal tracts in the medulla. Clinical diagnosis of HGPPS was confirmed by sequencing of ROBO3 gene, IVS4–1G > A (c.767–1G > A) and c.328_329delinsCCC (p.Asp110Profs*57) compound heterozygous variations were found, and segregated in parents. The younger boy was first reported at 16 months of age and had the same clinical and neuroradiological findings, unlike mild psychomotor retardation. ROBO3 gene analysis showed the same variants in his brother. Our cases show the importance of evaluating eye movements in children with neurodevelopmental abnormalities and looking for brainstem abnormalities in children with bilateral horizontal gaze palsy.
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Affiliation(s)
- Adnan Deniz
- Department of Pediatrics, Division of Child Neurology, Kocaeli Universitesi, Kocaeli, Turkey
| | - Sinan Çomu
- Department of Pediatrics, Division of Child Neurology, Anadolu Health Center, Kocaeli, Turkey
| | - Mesut Güngör
- Department of Pediatrics, Division of Child Neurology, Kocaeli Universitesi, Kocaeli, Turkey
| | - Yonca Anık
- Deparment of Radiology, Kocaeli University, Kocaeli, Turkey
| | - Bülent Kara
- Department of Pediatrics, Division of Child Neurology, Kocaeli Universitesi, Kocaeli, Turkey
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Bouchoucha S, Chikhaoui A, Najjar D, Dallali H, Khammessi M, Abdelhak S, Nessibe N, Shboul M, Kircher SG, Al Kaissi A, Yacoub-Youssef H. Clinical and Genetic Heterogeneity in Six Tunisian Families With Horizontal Gaze Palsy With Progressive Scoliosis: A Retrospective Study of 13 Cases. Front Pediatr 2020; 8:172. [PMID: 32373565 PMCID: PMC7179758 DOI: 10.3389/fped.2020.00172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 03/25/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Horizontal Gaze Palsy with Progressive Scoliosis (HGPPS) is a rare autosomal recessive congenital disorder characterized by the absence of conjugate horizontal eye movements, and progressive debilitating scoliosis during childhood and adolescence. HGPPS is associated with mutations of the ROBO3 gene. In this study, the objective is to identify pathogenic variants in a cohort of Tunisian patients with HGPPS and to further define ROBO3 genotype-phenotype correlations. Methods: Thirteen Tunisian patients from six unrelated consanguineous families all manifesting HGPPS were genetically investigated. We searched for the causative variants for HGPPS using classical Sanger and whole exome sequencing. Results: Four distinct homozygous mutations were identified in ROBO3 gene. Two of these were newly identified homozygous and non-synonymous mutations, causing effectively damage to the protein by in silico analysis. The other two mutations were previously reported in Tunisian patients with HGPPS. Mutations were validated by Sanger sequencing in parents and affected individuals. Conclusion: To the best of our knowledge, this is the largest ever reported cohort on families with HGPPS in whom ROBO3 mutations were identified. These molecular findings have expanded our knowledge of the ROBO3 mutational spectrum. The relevance of our current study is two-fold; first to assist proper management of the scoliosis and second to protect families at risk.
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Affiliation(s)
- Sami Bouchoucha
- Laboratoire de Génomique Biomédicale et Oncogénétique, LR16IPT05, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia.,Service Orthopédie, Hôpital d'enfant Béchir Hamza, Tunis, Tunisia
| | - Asma Chikhaoui
- Laboratoire de Génomique Biomédicale et Oncogénétique, LR16IPT05, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Dorra Najjar
- Laboratoire de Génomique Biomédicale et Oncogénétique, LR16IPT05, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Hamza Dallali
- Laboratoire de Génomique Biomédicale et Oncogénétique, LR16IPT05, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Maleke Khammessi
- Laboratoire de Génomique Biomédicale et Oncogénétique, LR16IPT05, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Sonia Abdelhak
- Laboratoire de Génomique Biomédicale et Oncogénétique, LR16IPT05, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Nabil Nessibe
- Service Orthopédie, Hôpital d'enfant Béchir Hamza, Tunis, Tunisia
| | - Mohammad Shboul
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Susanne G Kircher
- Institute of Medical Chemistry, Medical University of Vienna, Vienna, Austria
| | - Ali Al Kaissi
- First Medical Department, Ludwig Boltzmann Institute of Osteology, Hanusch Hospital of WGKK, AUVA Trauma Centre Meidling, Hanusch Hospital, Vienna, Austria.,Pediatric Department, Orthopaedic Hospital of Speising, Vienna, Austria
| | - Houda Yacoub-Youssef
- Laboratoire de Génomique Biomédicale et Oncogénétique, LR16IPT05, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
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Dolar Bilge A. Horizontal Gaze Palsy with Progressive Scoliosis: A Case Report and Literature Review. Neuroophthalmology 2019; 43:334-336. [PMID: 31741681 PMCID: PMC6844527 DOI: 10.1080/01658107.2018.1520901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 08/07/2018] [Accepted: 08/27/2018] [Indexed: 10/27/2022] Open
Abstract
Horizontal gaze palsy with progressive scoliosis (HGPPS) is a rare autosomal recessive disorder. The ROBO 3 gene mutation is responsible for the disease. We present a boy aged 12 years who was admitted for scoliosis surgery who had also had horizontal gaze palsy since birth. His brainstem abnormalities were compatible with the syndrome of HGPPS. HGPPS is one of the rare congenital diseases of childhood. Horizontal gaze palsy, ametropia, and progressive scoliosis are the main findings of the disease. This syndrome should be kept in mind for both ophthalmologists and orthopaedic surgeons in patients who present with gaze palsy and scoliosis. Early diagnosis of scoliosis makes it possible to treat the disease at an early stage, and early diagnosis of ametropia is important in the prevention of amblyopia.
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Affiliation(s)
- Ayse Dolar Bilge
- Department of Ophthalmology, Emsey Hospital, Pendik, Istanbul, Turkey
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