title: Early features in neuroimaging of two siblings with molybdenum cofactor deficiency.
abstract: We report the features of neuroimaging within 24 hours after birth in 2 siblings with molybdenum cofactor deficiency. The first sibling was delivered by emergency cesarean section because of fetal distress and showed pedaling and crawling seizures soon after birth. Brain ultrasound revealed subcortical multicystic lesions in the frontal white matter, and brain MRI at 4 hours after birth showed restricted diffusion in the entire cortex, except for the area adjacent to the subcortical cysts. The second sibling was delivered by elective cesarean section. Cystic lesions were seen in the frontal white matter on ultrasound, and brain MRI showed low signal intensity on T1-weighted image and high signal intensity on T2-weighted image in bifrontal white matter within 24 hours after birth, at which time the infant sucked sluggishly. Clonic spasm appeared at 29 hours after birth. The corpus callosum could not be seen clearly on ultrasound or MRI in both infants. Cortical atrophy and white matter cystic lesions spread to the entire hemisphere and resulted in severe brain atrophy within ~1 month in both infants. Subcortical multicystic lesions on ultrasound and a cortex with nonuniform, widespread, restricted diffusion on diffusion-weighted images are early features of neuroimaging in patients with molybdenum cofactor deficiency type A.
authors.affiliation: Department of Perinatal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-0012, Japan. rhiguchi@wakayama-med.ac.jp.
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Higuchi
authors.forename: Takuya
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Akira
authors.initials: A
authors.lastname: Tamura
authors.forename: Naomi
authors.initials: N
authors.lastname: Kioka
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Tsuno
authors.forename: Asumi
authors.initials: A
authors.lastname: Higa
authors.forename: Norishige
authors.initials: N
authors.lastname: Yoshikawa
mesh_terms: D001921:Brain / Q000473:pathology; D004453:Echoencephalography; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D008664:Metal Metabolism, Inborn Errors / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008983:Molybdoferredoxin; D035781:Siblings
chemical_list: D008983:Molybdoferredoxin
keywords: diffusion weighted image; magnetic resonance image; molybdenum cofactor deficiency; neuroimaging; ultrasound diagnosis