Cerebral gigantism (Sotos' syndrome). A rare cause of delayed walking and awkward gait

Sotos Syndrome: A case report

Sotos Syndrome is a genetic condition characterized by accelerated bone development, abnormal craniofacial morphology and psychomotor developmental retardation. The behavioral problems usually associated with the syndrome include poor social skills, anxiety and/or irritability. Oral findings include prognathism and a high-arched palate with premature eruption of the teeth. Delayed psychomotor development increases the risk for caries. A personalized preventive treatment plan with close supervision of the patient's oral health care is required. This paper documents a child diagnosed with Sotos Syndrome and describes the primary clinical features, the disease-specific craniofacial, oral and dental findings, and dental care management of this patient.

Genetics of Sotos syndrome

PURPOSE OF REVIEW

Sotos syndrome (SoS) (OMIM #117550) is a childhood overgrowth syndrome characterized by excessive growth, distinctive craniofacial features, developmental delay, and advanced bone age. Recently, haploinsufficiency of the NSD1 gene has been identified as the major cause of SoS, with intragenic mutations or submicroscopic microdeletions being found in about 60 to 75% of clinically diagnosed patients with SoS.

RECENT FINDINGS

Recent reports provided much information about the genetic background of SoS, the NSD gene family, and genotype-phenotype correlation. They also added new perspectives in the discussion about a possible association between SoS and neoplasia.

SUMMARY

This review focuses on recent genetic developments in SoS. Clinical features and associated anomalies are reviewed in relation to possible functional roles of NSD1. Genotype-phenotype correlation between patients with SoS harboring either intragenic mutations or microdeletions is discussed as well as their implication for possible revision of the diagnostic criteria of SoS. Furthermore, future prospects in genetic research of SoS are presented.

Aggressive behavior in patients with Sotos syndrome

Sotos syndrome is characterized by peculiar facies, prenatal and postnatal overgrowth, and developmental delay. The course of six patients with psychiatric, neurologic, and magnetic resonance imaging evaluations is reported. Three (50%) of the six patients were observed to have a tendency toward aggressiveness, including one who had pyromania.