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Wildervanck's syndrome and mirror movements: a congenital disorder of axon migration?
[holt-oram syndrome]
Cell
outgrowth
and
migration
in
the
developing
nervous
system
result
from
guidance
cues
,
whose
molecular
bases
and
clinical
correlates
are
only
partly
known
.
We
describe
a
patient
with
brain
stem
malformation
,
paroxysmal
left
sided
lacrimation
when
eating
(
"
crocodile
tears
"
)
and
mirror
movements
in
addition
to
Wildervanck
's
cervico-oculo-acusticus
(
COA
)
syndrome
,
which
encompasses
Klippel-
Feil
anomaly
,
congenital
hearing
loss
and
Duane
's
syndrome
.
The
unique
symptom
constellation
has
not
been
reported
in
that
combination
before
and
can
be
discussed
in
the
context
of
congenital
disordered
axonal
migration
based
on
dysfunction
of
signalling
pathways
.
However
,
mutations
in
some
recently
discovered
genes
,
associated
with
single
findings
also
present
in
our
patient
,
were
not
found
.
Therefore
,
we
suppose
that
the
disturbance
of
an
as
yet
unknown
regulatory
factor
may
explain
the
congenital
malformation
syndrome
of
our
patient
.
In
general
,
only
a
few
human
disorders
have
yet
been
found
to
result
from
defects
in
axon
guidance
.
Nevertheless
,
disorders
of
axon
guidance
can
certainly
be
regarded
as
a
new
category
of
neurodevelopmental
disorders
.
Diseases
Validation
Diseases presenting
"brain stem malformation"
symptom
holt-oram syndrome
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