6q terminal deletion syndrome associated with a distinctive EEG and clinical pattern: a report of five cases.
OBJECTIVE
Mental retardation, facial dysmorphisms, and neurologic and brain abnormalities are features of 6q terminal deletions. Epilepsy is frequently associated with this chromosome abnormality, but electroclinical findings are not well delineated. We report five unrelated patients with 6q terminal deletions and a peculiar clinical, EEG, and neuroradiologic picture of epilepsy, mental retardation, and colpocephaly.


METHODS
These three male and two female patients underwent general and neurologic examinations, repeated awake and sleep EEGs, and brain magnetic resonance imaging (MRI). A cytogenetic study and fluorescent in situ hybridization (FISH) with chromosome-specific subtelomeric probes were carried out in all cases.


RESULTS
All subjects had seizures characterized by vomiting, cyanosis, and head and eye version, with and without loss of consciousness. In four cases, EEGs showed posterior spike-and-wave complexes, which were activated by sleep. No patient had status epilepticus or prolonged seizures. Brain MRI revealed colpocephaly and dysgenesis of the corpus callosum and brainstem in four patients; three of them also had hypertrophic massa intermedia. FISH analysis revealed a 6q terminal deletion in all patients, which ranged between 9 Mb (cases 2 and 3) and 16 Mb (case 4).


CONCLUSIONS
We suggest that epilepsy associated with 6q terminal deletions is a new entity. Patients with dysmorphic features associated with focal occipital epilepsy, colpocephaly, and dysgenesis of the corpus callosum, thalami, and brainstem should be considered candidates for testing for 6q subtelomere deletions.
Elia
Maurizio
M
Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Enna, Italy. melia@oasi.en.it
Striano
Pasquale
P
Fichera
Marco
M
Gaggero
Roberto
R
Castiglia
Lucia
L
Galesi
Ornella
O
Malacarne
Michela
M
Pierluigi
Mauro
M
Amato
Carmelo
C
Musumeci
Sebastiano A
SA
Romano
Corrado
C
Majore
Silvia
S
Grammatico
Paola
P
Zara
Federico
F
Striano
Salvatore
S
Faravelli
Francesca
F