Resumen
El sÃndrome de Miller-Dieker es una entidad que se caracteriza por una lisencefalia tipo I, microcefalia, frente prominente, estrechamiento craneal bitemporal, nariz estrecha con narinas antevertidas, labio superior prominente y micrognatia, ocasionada por mutaciones en el cromosoma 17p13, y que se manifiesta con retraso psicomotor severo, epilepsia de difÃcil control y trastornos de la alimentación.
Presentamos el caso de una niña de 7,5 meses, con retraso psicomotor, epilepsia de difÃcil control, perÃmetro craneal en el lÃmite bajo de la normalidad, frente prominente y micrognatia, en la que se comprobó una lisencefalia tipo I mediante resonancia magnética y la deleción del gen LIS1 mediante hibridación in situ (FISH).
El sÃndrome de Miller-Dieker debe sospecharse ante un paciente con lisencefalia tipo I, los rasgos fenotÃpicos descritos y convulsiones de difÃcil control. El estudio genético mediante FISH resulta útil tanto para el diagnóstico definitivo como para el consejo genético.
Abstract
Introduction: Miller-Dieker syndrome is characterized by type I lissencephaly, microcephaly, prominent forehead, bitemporal hollowing, short nose with upturned nares, protuberant upper lip with a thin vermilion border, and small jaw. It is caused by different mutations on chromosome 17p13, and the clinical manifestations consist of severe psychomotor retardation, epilepsy with a poor response to treatment and eating disorders.
Case report: We describe the case of a 7.5-month-old girl with psychomotor retardation, severe epilepsy with a poor response to treatment, head circumference at the lower limit of normal range, prominent forehead and small jaw. Magnetic resonance imaging confirmed the diagnosis of type I lissencephaly and fluorescence in situ hybridization (FISH) revealed deletion of the LIS1 gene.
Comments: Miller-Dieker Syndrome should be suspected in any patient with type I lissencephaly, the phenotype described above and severe seizures. The genetic study by means of FISH is useful for both the diagnosis and genetic counselling.