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Kharrat M, Triki C, Ben Isaa A, Bouchaala W, Alila O, Chouchen J, Ghouliya Y, Kamoun F, Tlili A, Fakhfakh F. Expanding the genetic and phenotypic spectrum of TRAPPC9 and MID2-related neurodevelopmental disabilities: report of two novel mutations, 3D-modelling, and molecular docking studies. J Hum Genet 2024:10.1038/s10038-024-01242-9. [PMID: 38467738 DOI: 10.1038/s10038-024-01242-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/13/2024]
Abstract
Intellectual disabilities (ID) and autism spectrum disorders (ASD) have a variety of etiologies, including environmental and genetic factors. Our study reports a psychiatric clinical investigation and a molecular analysis using whole exome sequencing (WES) of two siblings with ID and ASD from a consanguineous family. Bioinformatic prediction and molecular docking analysis were also carried out. The two patients were diagnosed with profound intellectual disability, brain malformations such as cortical atrophy, acquired microcephaly, and autism level III. The neurological and neuropsychiatric examination revealed that P2 was more severely affected than P1, as he was unable to walk, presented with dysmorphic feature and exhibited self and hetero aggressive behaviors. The molecular investigations revealed a novel TRAPPC9 biallelic nonsense mutation (c.2920 C > T, p.R974X) in the two siblings. The more severely affected patient (P2) presented, along with the TRAPPC9 variant, a new missense mutation c.166 C > T (p.R56C) in the MID2 gene at hemizygous state, while his sister P1 was merely a carrier. The 3D modelling and molecular docking analysis revealed that c.166 C > T variant could affect the ability of MID2 binding to Astrin, leading to dysregulation of microtubule dynamics and causing morphological abnormalities in the brain. As our knowledge, the MID2 mutation (p.R56C) is the first one to be detected in Tunisia and causing phenotypic variability between the siblings. We extend the genetic and clinical spectrum of TRAPPC9 and MID2 mutations and highlights the possible concomitant presence of X-linked as well as autosomal recessive inheritance to causing ID, microcephaly, and autism.
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Affiliation(s)
- Marwa Kharrat
- Laboratory of Molecular and Functional Genetics, Faculty of Sciences of Sfax University, Sfax, Tunisia.
| | - Chahnez Triki
- Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia
- Research laboratory (LR19ES15), Sfax Medical School, Sfax University, Sfax, Tunisia
| | - Abir Ben Isaa
- Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia
- Research laboratory (LR19ES15), Sfax Medical School, Sfax University, Sfax, Tunisia
| | - Wafa Bouchaala
- Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia
- Research laboratory (LR19ES15), Sfax Medical School, Sfax University, Sfax, Tunisia
| | - Olfa Alila
- Laboratory of Molecular and Functional Genetics, Faculty of Sciences of Sfax University, Sfax, Tunisia
| | - Jihen Chouchen
- Department of Applied Biology, College of Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Yosra Ghouliya
- Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia
- Research laboratory (LR19ES15), Sfax Medical School, Sfax University, Sfax, Tunisia
| | - Fatma Kamoun
- Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia
- Research laboratory (LR19ES15), Sfax Medical School, Sfax University, Sfax, Tunisia
| | - Abdelaziz Tlili
- Department of Applied Biology, College of Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Faiza Fakhfakh
- Laboratory of Molecular and Functional Genetics, Faculty of Sciences of Sfax University, Sfax, Tunisia.
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Ben Issa A, Kamoun F, Bouchaala W, Charfi Triki C, Fakhfakh F. Complex genotypes in family with metachromatic leukodystrophy: Effect of trans and cis mutations distribution on the phenotype variability. Int J Dev Neurosci 2024; 84:35-46. [PMID: 37848385 DOI: 10.1002/jdn.10306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/08/2023] [Accepted: 10/04/2023] [Indexed: 10/19/2023] Open
Abstract
Metachromatic leukodystrophy (MLD) is a severe metabolic disorder caused by the deficient activity of arylsulfatase A due to ARSA gene mutations. According to the age of onset, MLD is classified into three forms: infantile, juvenile, and adult. In our study, we aimed to perform a genetic analysis for two siblings with juvenile MLD for a better characterization of the molecular mechanisms behind the disease. A consanguineous family including two MLD patients (PII.1 and PII.2) was enrolled in our study. The diagnosis was made based on the clinical and neuroimaging investigations. The sequencing of ARSA gene was performed followed by in silico analysis. Besides, the cis/trans distribution of the variants was verified through a PCR-RFLP. The ARSA gene sequencing revealed three known variants, two exonic c.1055A > G and c.1178C > G and an intronic one (c.1524 + 95A > G) in the 3'UTR region. All variants were present at heterozygous state in the two siblings and their mother. The assessment of the cis/trans distribution showed the presence of these variants in cis within the mother, while PII.2 and PII.2 present the c.1055A > G/c.1524 + 95A > G and the c.1178C > G in trans. Additionally, PII.1 harbored a de novo novel missense variant c.1119G > T, whose pathogenicity was supported by our predictive results. Our genetic findings, supported by a clinical examination, confirmed the affection of the mother by the adult MLD. Our results proved the implication of the variable distribution of the found variants in the age of MLD onset. Besides, we described a variable severity between the two siblings due to the de novo pathogenic variant. In conclusion, we identified a complex genotype of ARSA variants within two MLD siblings with a variable severity due to a de novo variant present in one of them. Our results allowed the establishment of an adult MLD diagnosis and highlighted the importance of an assessment of the trans/cis distribution in the cases of complex genotypes.
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Affiliation(s)
- Abir Ben Issa
- Laboratory of Molecular and Functional Genetics, Faculty of Science of Sfax, University of Sfax, Sfax, Tunisia
- Research laboratory "Neuropédiatrie" (LR19ES15), Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Fatma Kamoun
- Research laboratory "Neuropédiatrie" (LR19ES15), Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
- Child Neurology Department, CHU Hedi Chaker, Sfax, Tunisia
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Wafa Bouchaala
- Research laboratory "Neuropédiatrie" (LR19ES15), Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
- Child Neurology Department, CHU Hedi Chaker, Sfax, Tunisia
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Chahnez Charfi Triki
- Research laboratory "Neuropédiatrie" (LR19ES15), Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
- Child Neurology Department, CHU Hedi Chaker, Sfax, Tunisia
- Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Faiza Fakhfakh
- Laboratory of Molecular and Functional Genetics, Faculty of Science of Sfax, University of Sfax, Sfax, Tunisia
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Bouchaala W, Laroussi S, Mzid Y, Maaloul I, Jallouli O, Zouari S, Ben Nsir S, Mnif Z, Kammoun F, Triki C. Moyamoya Angiopathy: An Underdiagnosed Cause of Ischemic Stroke in a Tunisian Pediatric Cohort. Pediatr Neurol 2024; 150:3-9. [PMID: 37925769 DOI: 10.1016/j.pediatrneurol.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 09/17/2023] [Accepted: 09/22/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Moyamoya angiopathy is a rare cerebral vasculopathy and an underdiagnosed cause of arterial ischemic stroke in children. We aim to report the clinical and radiological presentations in a Tunisian pediatric cohort. METHODS We identified moyamoya angiopathy in pediatric patients managed at the Child Neurology Department of Hedi Chaker Sfax University Hospital between 2008 and 2020 and reviewed their clinical and radiological data as well as their evolutionary profile. RESULTS We collected 14 patients with median age 40.6 months and a female predominance (sex ratio of 0.75). An arterial ischemic stroke (AIS) revealed the disease in all patients, with the major symptom being a motor deficit. Symptoms related to a transient ischemic attack before the diagnostic consultation were reported in four patients. Carotid territory was, clinically and radiologically, the most frequently involved. Brain magnetic resonance imaging with angiography was performed in 12 patients confirming the diagnosis by revealing the development of collateral vessels. All the investigations concluded to moyamoya disease in 57.2% and moyamoya syndrome in 42.8%. The latter was related to Down syndrome in five patients and neurofibromatosis type 1 in one patient. With a mean follow-up of 2.35 years, two patients had at least two more AISs during the first two years following diagnosis and 42.8% of patients were diagnosed with vascular or poststroke epilepsy. Full recovery was noted in 14.3% of cases. CONCLUSIONS Moyamoya angiopathy in children is a serious condition that needs to be recognized due to the high risk of recurrent ischemic strokes.
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Affiliation(s)
- Wafa Bouchaala
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Sirine Laroussi
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia.
| | - Yosra Mzid
- Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Imen Maaloul
- Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia; Radiology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
| | - Olfa Jallouli
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Salma Zouari
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Sihem Ben Nsir
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Zeineb Mnif
- Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia; Radiology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia
| | - Fatma Kammoun
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
| | - Chahnez Triki
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Sfax, Tunisia; Search Laboratory "Neuropediatrie" LR19ES15 Sfax University, Sfax, Tunisia
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Zouari Mallouli S, Jallouli O, Bouchaala W, Ben Nsir S, Kamoun Feki F, Charfi Triki C. Challenges to associate early onset epilepsy with COVID-19 autoimmune encephalitis: A case report. World J Immunol 2023; 13:1-10. [DOI: 10.5411/wji.v13.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/14/2023] [Accepted: 02/02/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Diagnosis of coronavirus disease 2019 (COVID-19)-related neurological events in the pediatric population is challenging. Overlapping clinical picture of children with altered neurological state and inborn errors of metabolism, in addition to the frequency of asymptomatic COVID-19 cases, pose the main challenges for diagnosis. Diagnostic approaches to the onset post-COVID 19 subacute encephalopathy are still troublesome as seronegative autoimmune encephalitis (AIE) is reported.
CASE SUMMARY A 27-mo-old boy was admitted for stormy refractory seizure of polymorphic semiology and altered mental status followed by various neuropsychiatric features that were suggestive of AIE. Brain magnetic resonance imaging and cerebrospinal fluid analysis were normal. Neither the immunological assessment, including viral serologies, antinuclear antibodies, autoimmune antibodies (NMDA, AMPA, CASPR2, LG11, GABARB, Hu, Yo, Ri, CV2, PNMA2, SOX1, Titin, amphiphysin, Recoverin), nor the metabolic assessment for lactate and pyruvate showed significant anomaly. Both positive history of COVID-19 infection and the findings of characteristic repetitive extreme delta brush played a key role in the diagnosis of COVID-19-related AIE. A remarkable improvement in the state of the child was noted after two pulse doses of intravenous Veino-globulin and high dose of intravenous Corticosteroid.
CONCLUSION Diagnostic biomarkers for AIE might aid effective treatment.
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Affiliation(s)
- Salma Zouari Mallouli
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
| | - Olfa Jallouli
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
| | - Wafa Bouchaala
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
| | - Sihem Ben Nsir
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
| | - Fatma Kamoun Feki
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
| | - Chahnez Charfi Triki
- Department of Child Neurology, Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax, Tunisia, Sfax 3029, Tunisia
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Guermazi A, Charfi N, Mnif M, Zouari A, Bouchaala W, Ben Ncir S, Kammoun F, Maalej M, Triki C. Burden level among parents of children with epilepsy. Eur Psychiatry 2022. [PMCID: PMC9567668 DOI: 10.1192/j.eurpsy.2022.2220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Family caregiving role of children with epilepsy involves managing the daily lives of these children with disabilities. This can lead to impaired physical and psychological health of the caregiver.
Objectives
To assess the level of burden among caregivers of children with epilepsy and to determine the factors associated with it.
Methods
It was a descriptive and analytical survey. It involved the caregivers of children with epilepsy who were admitted to the pediatric neurology department at the Hedi Chaker University Hospital in Sfax during the period from July to October 2020. We used the 12-item Zarit (ZBI-12), the State-Trait-Anxiety Inventory (STAI), and the “BECK” Depression Inventory (BDI-13) to assess caregiver burden, anxiety and depression respectively.
Results
Forty-four caregivers participated in the survey. Their average age was 36 years and their relationship with patient was mother in 93.2% of cases. Among 44 children with epilepsy, 56.8% were boys and 34.1% were schooled. They had psychiatric comorbidity in 15.9% of cases. According to the ZBI scale, the level of burden was high in 45.5% of cases. The total ZBI score was significantly higher among caregivers with primary school level (p=0.05) and those with somatic disease (p=0.004). It was not correlated with the presence of child’s dependence on the others (p=0.20). High levels of depression, anxiety-state, and anxiety-trait among caregivers were correlated with the level of burden (p 0.000; 0.000 and 0.001, respectively).
Conclusions
Being a caregiver of a child with epilepsy is a burdensome circumstance. Hence the importance of offering psychological assistance for these caregivers.
Disclosure
No significant relationships.
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Zouari A, Charfi N, Guermazi A, Mnif M, Bouchaala W, Ben Ncir S, Kammoun F, Maalej M, Triki C. The assessment of family caregivers’ anxiety in pediatric epilepsy : a cross-sectional sudy. Eur Psychiatry 2022. [PMCID: PMC9567004 DOI: 10.1192/j.eurpsy.2022.996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Pediatric epilepsy is a debilitating disease that impacts not only children with epilpsy but also persons arround them. It is often considered as a source of anxiety for family caregivers.
Objectives
Assess the level of anxiety in caregivers of children with epilepsy and to identify factors related to it.
Methods
We conducted a cross-sectional, descriptive and analytical study between July and October 2020. It included caregivers of children with epilepsy hospitalized in the pediatric neurology department of Sfax. We used the STAI-Y scale to assess the level of state anxiety (STAI-AE).
Results
Forty four womens participated in our study. Low socio-economic level was found in 31.8% of cases. The average age of children was 4.9 years. The mean duration of epilepsy was 2.2 years. It was comorbid with an autism spectrum disorder or an intellectual disability in 15.9% of cases. In 70.5% of the cases, the children were dependent on their caregivers in their daily lives. The level of anxiety was moderate in 27.3% and high to very high in 13.6% of them. A higher state-anxiety score was correlated with a longer duration of epilepsy (p=0.033), a lower familial socioeconomic level (p=0.013) and a higher number of children in family (p=0.048).
Conclusions
Pediatric epilepsy is associated with significant level of anxiety in family caregivers. This anxiety increases with the duration of the disease and with the presence of socioeconomic and family difficulties. Thus, psychosocial support for caregivers should be integrated into a global approach of the disease.
Disclosure
No significant relationships.
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Guermazi A, Charfi N, Mnif M, Zouari A, Bouchaala W, Ben Ncir S, Kammoun F, Maalej M, Triki C. Burden level among parents of children with epilepsy. Eur Psychiatry 2022. [PMCID: PMC9565746 DOI: 10.1192/j.eurpsy.2022.816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Family caregiving role of children with epilepsy involves managing the daily lives of these children with disabilities. This can lead to impaired physical and psychological health of the caregiver. Objectives To assess the level of burden among caregivers of children with epilepsy and to determine the factors associated with it. Methods It was a descriptive and analytical survey. It involved the caregivers of children with epilepsy who were admitted to the pediatric neurology department at the Hedi Chaker University Hospital in Sfax during the period from July to October 2020. We used the 12-item Zarit (ZBI-12), the State-Trait-Anxiety Inventory (STAI), and the “BECK” Depression Inventory (BDI-13) to assess caregiver burden, anxiety and depression respectively. Results Forty-four caregivers participated in the survey. Their average age was 36 years and their relationship with patient was mother in 93.2% of cases. Among 44 children with epilepsy, 56.8% were boys and 34.1% were schooled. They had psychiatric comorbidity in 15.9% of cases. According to the ZBI scale, the level of burden was high in 45.5% of cases. The total ZBI score was significantly higher among caregivers with primary school level (p=0.05) and those with somatic disease (p=0.004). It was not correlated with the presence of child’s dependence on the others (p=0.20). High levels of depression, anxiety-state, and anxiety-trait among caregivers were correlated with the level of burden (p 0.000; 0.000 and 0.001, respectively). Conclusions Being a caregiver of a child with epilepsy is a burdensome circumstance. Hence the importance of offering psychological assistance for these caregivers. Disclosure No significant relationships.
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Chakroun S, Sellami S, Adouania M, Bouchaala W, Zouari S, Kammoun F, Triki C. Relations entre les anomalies de l’EEG et l’évolution neurodéveloppementale de l’épilepsie partielle bénigne atypique de l’enfant. Rev Neurol (Paris) 2022. [DOI: 10.1016/j.neurol.2022.02.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Maalej M, Kammoun F, Kharrat M, Bouchaala W, Ammar M, Mkaouar-Rebai E, Triki C, Fakhfakh F. A first description of ataxia with vitamin E deficiency associated with MT-TG gene mutation. Acta Neurol Belg 2021; 121:1733-1740. [PMID: 32979145 DOI: 10.1007/s13760-020-01490-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 09/04/2020] [Indexed: 11/26/2022]
Abstract
Ataxia with isolated vitamin E deficiency (AVED) is a rare autosomal recessive cerebellar ataxia disorder that is caused by a mutation in the alpha-tocopherol transfer protein gene TTPA, leading to a lower level of serum vitamin E. Although it is almost clinically similar to Friedreich's ataxia, its devastating neurological features can be prevented with appropriate treatment. In this study, we present a patient who was initially diagnosed with Friedreich's ataxia, but was later found to have AVED. Frataxin gene screening revealed the absence of GAA expansion in homozygous or heterozygous state. However, TTPAgene sequencing showed the presence of the c.744delA mutation, leading to a premature stop codon (p.E249fx). In addition, the result of mutational analysis of MT-DNA genes revealed the presence of several variants, including the m.10044A>G mutation in MT-TG gene. Here, we report for the first time the coexistence of both mitochondrial and nuclear genes mutations in AVED.
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Affiliation(s)
- Marwa Maalej
- Laboratory of Molecular and Functional Genetics, Faculty of Science of Sfax, Sfax, Tunisia.
| | - Fatma Kammoun
- Unit of Pediatric Neurology research (UR12ES 16), C.H.U. Hedi Chaker, Sfax, Tunisia
| | - Marwa Kharrat
- Laboratory of Molecular and Functional Genetics, Faculty of Science of Sfax, Sfax, Tunisia
| | - Wafa Bouchaala
- Unit of Pediatric Neurology research (UR12ES 16), C.H.U. Hedi Chaker, Sfax, Tunisia
| | - Marwa Ammar
- Laboratory of Molecular and Functional Genetics, Faculty of Science of Sfax, Sfax, Tunisia
| | - Emna Mkaouar-Rebai
- Laboratory of Molecular and Functional Genetics, Faculty of Science of Sfax, Sfax, Tunisia
| | - Chahnez Triki
- Unit of Pediatric Neurology research (UR12ES 16), C.H.U. Hedi Chaker, Sfax, Tunisia
| | - Faiza Fakhfakh
- Laboratory of Molecular and Functional Genetics, Faculty of Science of Sfax, Sfax, Tunisia.
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Ben Ayed I, Bouchaala W, Bouzid A, Feki W, Souissi A, Ben Nsir S, Ben Said M, Sammouda T, Majdoub F, Kharrat I, Kamoun F, Elloumi I, Kamoun H, Tlili A, Masmoudi S, Triki C. Further insights into the spectrum phenotype of TRAPPC9 and CDK5RAP2 genes, segregating independently in a large Tunisian family with intellectual disability and microcephaly. Eur J Med Genet 2021; 64:104373. [PMID: 34737153 DOI: 10.1016/j.ejmg.2021.104373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 10/06/2021] [Accepted: 10/27/2021] [Indexed: 10/20/2022]
Abstract
Intellectual disability (ID) often co-occurs with other neurologic phenotypes making molecular diagnosis more challenging particularly in consanguineous populations with the co-segregation of more than one ID-related gene in some cases. In this study, we investigated the phenotype of three patients from a large Tunisian family with significant ID phenotypic variability and microcephaly and performed a clinical exome sequencing in two cases. We identified, within the first branch, a homozygous variant in the TRAPPC9 gene (p.Arg472Ter) in two cases presenting severe ID, absent speech, congenital/secondary microcephaly in addition to autistic features, supporting the implication of TRAPPC9 in the "secondary" autism spectrum disorders and congenital microcephaly. In the second branch, we identified a homozygous variant (p.Lys189ArgfsTer15) in the CDK5RAP2 gene associated with an heterozygous TRAPPC9 variant (p.Arg472Ter) in one case harbouring primary hereditary microcephaly (MCPH) associated with an inter-hypothalamic adhesion, mixed hearing loss, selective thinning in the retinal nerve fiber layer and parafoveal ganglion cell complex, and short stature. Our findings expand the spectrum of the recently reported neurosensorial abnormalities and revealed the variable phenotype expressivity of CDK5RAP2 defect. Our study highlights the complexity of the genetic background of microcephaly/ID and the efficiency of the exome sequencing to provide an accurate diagnosis and to improve the management and follow-up of such patients.
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Affiliation(s)
- Ikhlas Ben Ayed
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Tunisia; Medical Genetics Department, University Hedi Chaker Hospital of Sfax, Tunisia.
| | - Wafa Bouchaala
- Child Neurology Department, University Hedi Chaker Hospital of Sfax, Tunisia; Research Laboratory "Neuropédiatrie" LR19ES15, Sfax University, Tunisia
| | - Amal Bouzid
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Tunisia; Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Wiem Feki
- Radiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Amal Souissi
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Tunisia
| | - Sihem Ben Nsir
- Child Neurology Department, University Hedi Chaker Hospital of Sfax, Tunisia; Research Laboratory "Neuropédiatrie" LR19ES15, Sfax University, Tunisia
| | - Mariem Ben Said
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Tunisia
| | - Takwa Sammouda
- Department of Ophthalmology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Fatma Majdoub
- Medical Genetics Department, University Hedi Chaker Hospital of Sfax, Tunisia
| | - Ines Kharrat
- Department of Otorhinolaryngology, University Habib Bourguiba Hospital of Sfax, Tunisia
| | - Fatma Kamoun
- Child Neurology Department, University Hedi Chaker Hospital of Sfax, Tunisia; Research Laboratory "Neuropédiatrie" LR19ES15, Sfax University, Tunisia
| | - Ines Elloumi
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Tunisia
| | - Hassen Kamoun
- Medical Genetics Department, University Hedi Chaker Hospital of Sfax, Tunisia; Laboratory of Human Molecular Genetics, LR33ES99, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Abdelaziz Tlili
- Department of Applied Biology, College of Sciences, University of Sharjah, Sharjah, United Arab Emirates; Human Genetics and Stem Cell Laboratory, Research Institute of Sciences and Engineering, University of Sharjah, Sharjah, United Arab Emirates
| | - Saber Masmoudi
- Laboratory of Molecular and Cellular Screening Processes (LPCMC), Center of Biotechnology of Sfax, University of Sfax, Tunisia
| | - Chahnez Triki
- Child Neurology Department, University Hedi Chaker Hospital of Sfax, Tunisia; Research Laboratory "Neuropédiatrie" LR19ES15, Sfax University, Tunisia
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Zouari R, Triki C, Bouchaala W, Nsir SB, Kamoun F. Mitochondrial leucoencephalopathies: An under-diagnosed form of mitochondrial disease. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.119364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Zouari R, Triki C, Bouchaala W, Nsir SB, Kamoun F. Peripheral neuropathy due to mitochondrial disorders in pediatric patients. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.119365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Zouari Mallouli S, Ben Nsir S, Bouchaala W, Kamoun Feki F, Charfi Triki C. Acute Demyelinating Syndromes: A report of child neurology department of Sfax University Hospital. Mult Scler Relat Disord 2021; 56:103291. [PMID: 34624647 DOI: 10.1016/j.msard.2021.103291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/26/2021] [Accepted: 09/27/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The yearly incidence of Acute Demyelinating Syndromes (ADS) in a multiethnic cohort of children published by Langer-Gould and al in 2011 was estimated at about 1.66 per 100,000. Nevertheless, the real incidence for these disorders is still underestimated as the iterative revision for diagnosis criteria have failed to classify a significant number of children with ADS. PURPOSE This work was aimed to describe clinical and paraclinical characteristics of ADS in a pediatric population. MATERIAL AND METHODS Demographic, clinical and paraclinical data of 42 children (24 females; 18 male; SR = 1.33), were collected from the medical records of patients admitted to the child neurology department of Sfax University Hospital between 2008 and 2021 for clinical events with presumed inflammatory origin. Next, patients were categorized as per M. N. Nouri and al. up dated classification for ADS. Finally, characteristics of different ADS categories were compared. RESULTS The mean age onset was 6 years (± 3.5 years). For a mean follow-up period of 28 months, 69% of patients had a monophasic course. ADS in our pediatric population were Acute disseminated encephalomyelitis (ADEM) (36%), Clinically isolated syndrome (CIS) (24%), Multiple sclerosis (MS) (19%), Neuromyelitis optica spectrum disorder (NMOSD) (7%), Myelin oligodendrocyte glycoprotein antibodies-associated diseases (MOGAD) (2%) and Recurrent demyelinating disease not otherwise specified (RD-NOS) (10%). At presentation, patients showed different clinical picture according to ADS-subtype with more patients with epileptic seizure in ADEM-group (53.3%), optic neuritis in CIS-group (70%), motor deficit in MS-group (62.5%), area postrema syndrome in NMOSD-group (33.3%) and vesico-sphincter dysfunction in RD-NOS-group (75%). Among patients presenting with visual impairment (21.4%), Visual evoked potential (VEP) guided the diagnosis of NMOSD in 22.2% by objectifying axonal optic nerve damage. Different ADS subtypes were identified according to MRI results in 100% of ADEM-patients and 75% of MS-patients and on antibody testing in three patients. The ADS-subtype was recognized based on antibody testing in three patients. Two patients from CIS-group: the first with isolated optic neuritis (ON) was positive for antiaquaporin 4 antibodies (anti-AQP4) and the other with clinically polyfocal ADS was positive for antinuclear antibodies (ANA) type anti-RNP. The remaining patients who presented with ADEM-phenotype was positive for anti-myelin oligodendrocyte glycoprotein (anti-MOG). SIGNIFICANCE Recognizing distinctive features of each ADS category may improve diagnosis accuracy as well as the indication of suitable treatment.
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Affiliation(s)
- Salma Zouari Mallouli
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Tunisia; Research laboratory LR19ES15, Sfax University, Tunisia.
| | - Sihem Ben Nsir
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Tunisia; Research laboratory LR19ES15, Sfax University, Tunisia
| | - Wafa Bouchaala
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Tunisia; Research laboratory LR19ES15, Sfax University, Tunisia
| | - Fatma Kamoun Feki
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Tunisia; Research laboratory LR19ES15, Sfax University, Tunisia
| | - Chahnez Charfi Triki
- Child Neurology Department, Hedi Chaker Sfax University Hospital, Tunisia; Research laboratory LR19ES15, Sfax University, Tunisia
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Charfi Triki C, Mguidich T, Bouchaala W, Ben Ncir S, Chaari H, Fourati E, Ketata S, Kallel R, Kamoun F. Knowledge and attitudes toward epilepsy among people in Sfax region, Tunisia. Epilepsy Behav 2021; 122:108151. [PMID: 34217034 DOI: 10.1016/j.yebeh.2021.108151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Epilepsy is one of the most stigmatizing disorders. Stigma and negative attitudes associated with epilepsy are due to poor public awareness and knowledge. This study evaluated knowledge, awareness, and attitude toward epilepsy among Tunisian general population. METHODS This was a cross-sectional study conducted between 2017 and 2019. On national epilepsy day on February and during awareness campaigns at Sfax Tunisia, we asked people who visited the epilepsy stand to anonymously answer a 31-item questionnaire on epilepsy. RESULTS Five hundred and four participants have been included. About 43.6% of participants had personal or familial history of epilepsy. More than seventy percent of subjects thought that epilepsy is a neurological disease and 34.1% believed it is psychiatric. Majority (92.1%) of our population believed that epilepsy is non-contagious but 37.7% thought it is hereditary and 55.8% thought it causes intellectual deficiency. EEG was the most reported diagnostic method (61.7%). The two most popular therapeutic modalities reported in our population were drug treatment alone (85.3%) and associated with Quran (35.3%). Most (91.1%) of people thought that a person with epilepsy can get married. A person with epilepsy is able to study according to 92.7% of respondents, but 66.3% assumed that he/she suffers from difficulty concentrating. Subjects younger than 45 years were more aware of the ability of people with epilepsy to study and get married. We did not find any significant differences in knowledge and attitudes between subjects familiar with epilepsy and the rest of the population. CONCLUSION The public knowledge and attitudes toward epilepsy were acceptable with regard to this study. However, negative attitudes and misunderstanding still exist.
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Affiliation(s)
- Chahnez Charfi Triki
- Research Laboratory (LR19ES15), Sfax Medical School, Sfax University, Tunisia; Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - Thouraya Mguidich
- Research Laboratory (LR19ES15), Sfax Medical School, Sfax University, Tunisia; Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia.
| | - Wafa Bouchaala
- Research Laboratory (LR19ES15), Sfax Medical School, Sfax University, Tunisia; Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - Sihem Ben Ncir
- Research Laboratory (LR19ES15), Sfax Medical School, Sfax University, Tunisia; Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia
| | - Hayet Chaari
- Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia; Mohamed Ali Dispensary, Sfax, Tunisia
| | - Emna Fourati
- Research Laboratory (LR19ES15), Sfax Medical School, Sfax University, Tunisia; Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia; Bir Ali Ben Khelifa Hospital, Sfax, Tunisia
| | - Sourour Ketata
- Research Laboratory (LR19ES15), Sfax Medical School, Sfax University, Tunisia; Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia; Mahres Hospital, Sfax, Tunisia
| | | | - Fatma Kamoun
- Research Laboratory (LR19ES15), Sfax Medical School, Sfax University, Tunisia; Child Neurology Department, Hedi Chaker Hospital, Sfax, Tunisia
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Zouari R, Bouchaala W, Nsir SB, Kamoun F, Triki C. Opsoclonus myoclonus induced by lamotrigine toxicity. Seizure 2021; 91:247-250. [PMID: 34243055 DOI: 10.1016/j.seizure.2021.06.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Rania Zouari
- Department of Child Neurology, Hedi Chaker University Hospital, Sfax, Tunisia.
| | - Wafa Bouchaala
- Department of Child Neurology, Hedi Chaker University Hospital, Sfax, Tunisia; Search Unit "Neuropédiatrie" UR12ES16, Sfax University, Sfax, Tunisia.
| | - Sihem Ben Nsir
- Department of Child Neurology, Hedi Chaker University Hospital, Sfax, Tunisia; Search Unit "Neuropédiatrie" UR12ES16, Sfax University, Sfax, Tunisia.
| | - Fatma Kamoun
- Department of Child Neurology, Hedi Chaker University Hospital, Sfax, Tunisia; Search Unit "Neuropédiatrie" UR12ES16, Sfax University, Sfax, Tunisia.
| | - Chahnez Triki
- Department of Child Neurology, Hedi Chaker University Hospital, Sfax, Tunisia; Search Unit "Neuropédiatrie" UR12ES16, Sfax University, Sfax, Tunisia.
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Kallel R, Mnif H, Bouchaala W, Sihem BN, Fatma K, Triki C. Les conductions nerveuses motrices des membres superieurs chez l’enfant : valeurs normales. Rev Neurol (Paris) 2020. [DOI: 10.1016/j.neurol.2020.01.175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bouattour N, Kamoun F, Charfi S, Nsir SB, Bouchaala W, Boudawara T, Triki C. Neurological Nuance: Sporadic Burkitt's Lymphoma Presenting with Guillain–Barre Syndrome. Journal of Pediatric Neurology 2020. [DOI: 10.1055/s-0040-1710515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AbstractBurkitt's lymphoma (BL) is a high-grade mature B cell neoplasm. Primary lymphoma of the central nervous system (CNS) is very rare. In contrast, BL can be localized in any part of the body and may spread to the CNS. Peripheral nervous system impairment caused by BL has been thoroughly described. However, Guillain–Barre syndrome (GBS) does not commonly appear as an initial manifestation of BL. We presented the case of a young child with sporadic BL with neuromeningeal involvement and spinal cord compression whose first clinical manifestation was the appearance of GBS. Lymphoma should be taken into account, especially in children presenting with the clinical features of acute polyradiculoneuropathy.
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Affiliation(s)
- Nadia Bouattour
- Department of Child Neurology, Hedi Chaker Hospital, Sfax, Tunisia
| | - Fatma Kamoun
- Department of Child Neurology, Hedi Chaker Hospital, Sfax, Tunisia
- Research Laboratory “Neuropediatrics,” University of Sfax, Sfax, Tunisia
| | - Slim Charfi
- Department of Pathology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Siham Ben Nsir
- Department of Child Neurology, Hedi Chaker Hospital, Sfax, Tunisia
- Research Laboratory “Neuropediatrics,” University of Sfax, Sfax, Tunisia
| | - Wafa Bouchaala
- Department of Child Neurology, Hedi Chaker Hospital, Sfax, Tunisia
- Research Laboratory “Neuropediatrics,” University of Sfax, Sfax, Tunisia
| | - Tahya Boudawara
- Department of Pathology, Habib Bourguiba Hospital, Sfax, Tunisia
| | - Chahnez Triki
- Department of Child Neurology, Hedi Chaker Hospital, Sfax, Tunisia
- Research Laboratory “Neuropediatrics,” University of Sfax, Sfax, Tunisia
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Ayadi B, Kamoun Feki F, Ben Nsir S, Bouchaala W, Mnif Z, Ben Jemaa M, Triki C. Brain Tuberculomas as BCGitis Complication Presenting with Epileptic Spasms: A Case Report. Journal of Pediatric Neurology 2020. [DOI: 10.1055/s-0039-1683870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AbstractCentral nervous system (CNS) BCGitis is a rare but a very severe complication of the Bacille Calmette–Guerin (BCG) vaccine. It could be a diagnostic challenge that may lead to a delay in treatment. A 5-month-old boy presented with infantile spasms, had posted natal BCG vaccination and developed brain tuberculomas as brain BCGitis. Laboratory findings were normal. He received 14 months of antitubercular regimen with good tolerance and both clinical and radiological improvement. The main difficulty in brain BCGitis is to make a diagnosis that requires histological or bacteriological examination. A good evolution without sequel could be seen if it is treated early.
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Affiliation(s)
- Basma Ayadi
- Child Neurology Department, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Fatma Kamoun Feki
- Child Neurology Department, Hedi Chaker University Hospital, Sfax, Tunisia
- Child Neurology Department Search Unit “Neuropédiatrie” UR12ES16, Sfax University, Tunisia
| | - Siham Ben Nsir
- Child Neurology Department, Hedi Chaker University Hospital, Sfax, Tunisia
- Child Neurology Department Search Unit “Neuropédiatrie” UR12ES16, Sfax University, Tunisia
| | - Wafa Bouchaala
- Child Neurology Department, Hedi Chaker University Hospital, Sfax, Tunisia
- Child Neurology Department Search Unit “Neuropédiatrie” UR12ES16, Sfax University, Tunisia
| | - Zeineb Mnif
- Radiology Department, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Mounir Ben Jemaa
- Department of Infectious Diseases, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Chahnez Triki
- Child Neurology Department, Hedi Chaker University Hospital, Sfax, Tunisia
- Child Neurology Department Search Unit “Neuropédiatrie” UR12ES16, Sfax University, Tunisia
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Bouattour N, KamounFeki F, Bouchaala W, Ben Nsir S, Triki C. Neurological Manifestations of Sanjad–Sakati Syndrome: New Three Reported Cases from Tunisia. Journal of Pediatric Neurology 2019. [DOI: 10.1055/s-0039-1698753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AbstractSanjad–Sakati syndrome (SSS), or hypoparathyroidism–mental retardation dysmorphism syndrome, is a rare autosomal recessive congenital disorder characterized by congenital hypoparathyroidism, growth and neurodevelopmental delay, acute symptomatic seizures due to hypocalcemia, and dysmorphic features. The syndrome is underdiagnosed, and neurological manifestations are not previously described. We report three Tunisian patients with SSS revealed by acute symptomatic hypocalcemic epileptic seizures. Despite the well-controlled seizures, patients tend to continue having poor growth and neurological outcome. The diagnosis of SSS allowed for proper treatment of the patients, prevented associated comorbidities, and provided genetic counseling to their families.
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Affiliation(s)
- Nadia Bouattour
- Department of Child Neurology, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Fatma KamounFeki
- Department of Child Neurology, Hedi Chaker University Hospital, Sfax, Tunisia
- Search Unit “Neuropédiatrie” UR12ES16, Sfax University, Sfax, Tunisia
| | - Wafa Bouchaala
- Department of Child Neurology, Hedi Chaker University Hospital, Sfax, Tunisia
- Search Unit “Neuropédiatrie” UR12ES16, Sfax University, Sfax, Tunisia
| | - Siham Ben Nsir
- Department of Child Neurology, Hedi Chaker University Hospital, Sfax, Tunisia
- Search Unit “Neuropédiatrie” UR12ES16, Sfax University, Sfax, Tunisia
| | - Chahnez Triki
- Department of Child Neurology, Hedi Chaker University Hospital, Sfax, Tunisia
- Search Unit “Neuropédiatrie” UR12ES16, Sfax University, Sfax, Tunisia
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Rania Z, Bouchaala W, Ben Nsir S, Kamoun F, Chahnez T. Les complications neurologiques de la maladie de CriglerNajjar. Rev Neurol (Paris) 2019. [DOI: 10.1016/j.neurol.2019.01.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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21
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Ben Nsir S, Belguith S, Bouchaala W, Fourati E, Kamoun F, Triki C. L’hypertension intracrânienne chez l’enfant : expérience du service de neurologie pédiatrique de Sfax. Rev Neurol (Paris) 2019. [DOI: 10.1016/j.neurol.2019.01.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Bouattour N, Farhat N, Bouchaala W, Kacem HH, Hdiji O, Sakka S, Dammak M, Mhiri C. EEG patterns and epileptic seizures in acute phase stroke. Neurophysiol Clin 2018. [DOI: 10.1016/j.neucli.2018.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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23
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Bouchaala W, Hdiji O, Farhat N, Hajkacem H, Dammak M, Mhiri C. Thrombose du sinus caverneux secondaire à la mucormycose rhino-cérébrale (à propos de deux observations). Rev Neurol (Paris) 2017. [DOI: 10.1016/j.neurol.2017.01.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bouchaala W, Dammak M, Bouzidi N, Bellaj H, Gorbel M, Elloumi M, Mhiri C. [Orbital apex syndrome revealing multiple myeloma]. Presse Med 2017; 46:449-452. [PMID: 28233702 DOI: 10.1016/j.lpm.2017.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 12/06/2016] [Accepted: 01/24/2017] [Indexed: 11/16/2022] Open
Affiliation(s)
- Wafa Bouchaala
- CHU Habib Bourguiba, service neurologie, 7, rue El-Ferdaous, 3029 Sfax, Tunisie; Université de Sfax, faculté de médecine, laboratoire de recherche en neurogénétique, maladie de Parkinson et maladies cérébro-vasculaires, LR-12-SP-19, boulevard Majida-Boulila, 3029 Sfax, Tunisie.
| | - Mariem Dammak
- CHU Habib Bourguiba, service neurologie, 7, rue El-Ferdaous, 3029 Sfax, Tunisie; Université de Sfax, faculté de médecine, laboratoire de recherche en neurogénétique, maladie de Parkinson et maladies cérébro-vasculaires, LR-12-SP-19, boulevard Majida-Boulila, 3029 Sfax, Tunisie
| | - Nouha Bouzidi
- CHU Habib Bourguiba, service neurologie, 7, rue El-Ferdaous, 3029 Sfax, Tunisie; Université de Sfax, faculté de médecine, laboratoire de recherche en neurogénétique, maladie de Parkinson et maladies cérébro-vasculaires, LR-12-SP-19, boulevard Majida-Boulila, 3029 Sfax, Tunisie
| | - Hatem Bellaj
- CHU Hédi Chaker, service d'hématologie, rue El-Ferdaous, 3029 Sfax, Tunisie
| | - Manel Gorbel
- CHU Hédi Chaker, service d'hématologie, rue El-Ferdaous, 3029 Sfax, Tunisie
| | - Moez Elloumi
- CHU Hédi Chaker, service d'hématologie, rue El-Ferdaous, 3029 Sfax, Tunisie
| | - Chokri Mhiri
- CHU Habib Bourguiba, service neurologie, 7, rue El-Ferdaous, 3029 Sfax, Tunisie; Université de Sfax, faculté de médecine, laboratoire de recherche en neurogénétique, maladie de Parkinson et maladies cérébro-vasculaires, LR-12-SP-19, boulevard Majida-Boulila, 3029 Sfax, Tunisie
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Zouari H, Bouchaala W, Ben Jemaa S, Kammoun R, Rekik S, Kammoun I, Masmoudi K. Anomalies électroencéphalographiques dans les crises fébriles, que doit-on en faire ? Neurophysiol Clin 2016. [DOI: 10.1016/j.neucli.2016.06.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Jerraya H, Bouchaala W, Chadli D. Education and Imaging. Hepatology: images of hydatid cyst of the liver mimicking an hepatic abscess. J Gastroenterol Hepatol 2014; 29:1662. [PMID: 25039694 DOI: 10.1111/jgh.12676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- H Jerraya
- Medical School of Tunis, Department "B" of General Surgery, Charles Nicolle Hospital, Tunis, Tunisia
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Bouchaala W, Kamoun F, Chaari D, Ben Ayed M, Triki C. Céphalées chroniques et retentissement scolaire chez les enfants en âge scolaire dans la région de Sfax (Tunisie). Rev Neurol (Paris) 2014. [DOI: 10.1016/j.neurol.2014.01.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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