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Norman-Roberts syndrome(LIS2)

MedGen UID:
163213
Concept ID:
C0796089
Disease or Syndrome
Synonyms: LIS2; Lissencephaly 2; Lissencephaly 2 (Norman-Roberts type); Lissencephaly syndrome Norman-Roberts type
SNOMED CT: Lissencephaly syndrome Norman Roberts type (717977003); Microlissencephaly type A (717977003)
Modes of inheritance:
Autosomal recessive inheritance
MedGen UID:
141025
Concept ID:
C0441748
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in individuals with two pathogenic alleles, either homozygotes (two copies of the same mutant allele) or compound heterozygotes (whereby each copy of a gene has a distinct mutant allele).
 
Gene (location): RELN (7q22.1)
 
Monarch Initiative: MONDO:0009760
OMIM®: 257320
Orphanet: ORPHA89844

Definition

Lissencephaly ('smooth brain') is a severe disorder of brain development in which neuronal migration is impaired, leading to a thickened cerebral cortex in which the normally folded contour is simplified and smooth. Lissencephaly-2 (LIS2) is associated with severe abnormalities of the cerebellum and hippocampus (summary by Hong et al., 2000). For a general phenotypic description and a discussion of genetic heterogeneity of lissencephaly, see LIS1 (607432). [from OMIM]

Additional description

From MedlinePlus Genetics
Lissencephaly with cerebellar hypoplasia (LCH) affects brain development, resulting in the brain having a smooth appearance (lissencephaly) instead of its normal folds and grooves. In addition, the part of the brain that coordinates movement is unusually small and underdeveloped (cerebellar hypoplasia). Other parts of the brain are also often underdeveloped in LCH, including the hippocampus, which plays a role in learning and memory, and the part of the brain that is connected to the spinal cord (the brainstem).

Individuals with LCH have moderate to severe intellectual disability and delayed development. They have few or no communication skills, extremely poor muscle tone (hypotonia), problems with coordination and balance (ataxia), and difficulty sitting or standing without support. Most affected children experience recurrent seizures (epilepsy) that begin within the first months of life. Some affected individuals have nearsightedness (myopia), involuntary eye movements (nystagmus), or puffiness or swelling caused by a buildup of fluids in the body's tissues (lymphedema).  https://medlineplus.gov/genetics/condition/lissencephaly-with-cerebellar-hypoplasia

Clinical features

From HPO
Generalized-onset seizure
MedGen UID:
115963
Concept ID:
C0234533
Disease or Syndrome
A generalized-onset seizure is a type of seizure originating at some point within, and rapidly engaging, bilaterally distributed networks. The networks may include cortical and subcortical structures but not necessarily the entire cortex.
Lissencephaly
MedGen UID:
78604
Concept ID:
C0266463
Finding
A spectrum of malformations of cortical development caused by insufficient neuronal migration that subsumes the terms agyria, pachygyria and subcortical band heterotopia. See also neuropathological definitions for 2-, 3-, and 4-layered lissencephaly.
Cerebellar hypoplasia
MedGen UID:
120578
Concept ID:
C0266470
Congenital Abnormality
Cerebellar hypoplasia is a descriptive term implying a cerebellum with a reduced volume, but a normal shape and is stable over time.
Classic lissencephaly
MedGen UID:
98463
Concept ID:
C0431375
Disease or Syndrome
Lissencephaly (LIS), literally meaning smooth brain, is characterized by smooth or nearly smooth cerebral surface and a paucity of gyral and sulcal development, encompassing a spectrum of brain surface malformations ranging from complete agyria to subcortical band heterotopia (SBH). Classic lissencephaly is associated with an abnormally thick cortex, reduced or abnormal lamination, and diffuse neuronal heterotopia. SBH consists of circumferential bands of heterotopic neurons located just beneath the cortex and separated from it by a thin band of white matter. SBH represents the less severe end of the lissencephaly spectrum of malformations (Pilz et al., 1999, summary by Kato and Dobyns, 2003). Agyria, i.e., brain without convolutions or gyri, was considered a rare malformation until recent progress in neuroradiology (Bordarier et al., 1986). With this technical advantage, a number of lissencephaly syndromes have been distinguished. Classic lissencephaly (formerly type I) is a brain malformation caused by abnormal neuronal migration at 9 to 13 weeks' gestation, resulting in a spectrum of agyria, mixed agyria/pachygyria, and pachygyria. It is characterized by an abnormally thick and poorly organized cortex with 4 primitive layers, diffuse neuronal heterotopia, enlarged and dysmorphic ventricles, and often hypoplasia of the corpus callosum (Lo Nigro et al., 1997). Kato and Dobyns (2003) presented a classification system for neuronal migration disorders based on brain imaging findings and molecular analysis. The authors also reviewed the contributions and interactions of the 5 genes then known to cause human lissencephaly: LIS1 (PAFAH1B1), 14-3-3-epsilon (YWHAE), DCX, RELN, and ARX. Genetic Heterogeneity of Lissencephaly Lissencephaly is a genetically heterogeneous disorder. See also LIS2 (257320), caused by mutation in the RELN gene (600514) on chromosome 7q22; LIS3 (611603), caused by mutation in the TUBA1A gene (602529) on chromosome 12q13; LIS4 (614019), caused by mutation in the NDE1 gene (609449) on chromosome 16p13; LIS5 (615191), caused by mutation in the LAMB1 gene (150240) on chromosome 7q31; LIS6 (616212), caused by mutation in the KATNB1 gene (602703) on chromosome 16q21; LIS7 (616342), caused by mutation in the CDK5 gene (123831) on chromosome 7q36; LIS8 (617255), caused by mutation in the TMTC3 gene (617218) on chromosome 12q21; LIS9 (618325), caused by mutation in the MACF1 gene (608271) on chromosome 1p34; and LIS10 (618873), caused by mutation in the CEP85L gene (618865) on chromosome 6q22. X-linked forms include LISX1 (300067), caused by mutation in the DCX gene (300121) on chromosome Xq23, and LISX2 (300215), caused by mutation in the ARX gene (300382) on chromosome Xp21. See also Miller-Dieker lissencephaly syndrome (MDLS; 247200), a contiguous gene microdeletion syndrome involving chromosome 17p13 and including the PAFAH1B1 and YWHAE (605066) genes. Lissencephaly caused by mutations in the PAFAH1B1 gene is also called 'isolated' lissencephaly to distinguish it from the accompanying features of MDLS.
Global developmental delay
MedGen UID:
107838
Concept ID:
C0557874
Finding
A delay in the achievement of motor or mental milestones in the domains of development of a child, including motor skills, speech and language, cognitive skills, and social and emotional skills. This term should only be used to describe children younger than five years of age.
Hypoplasia of the pons
MedGen UID:
341246
Concept ID:
C1848529
Finding
Underdevelopment of the pons.
Thick cerebral cortex
MedGen UID:
870522
Concept ID:
C4024970
Anatomical Abnormality
Hypotonia
MedGen UID:
10133
Concept ID:
C0026827
Finding
Hypotonia is an abnormally low muscle tone (the amount of tension or resistance to movement in a muscle). Even when relaxed, muscles have a continuous and passive partial contraction which provides some resistance to passive stretching. Hypotonia thus manifests as diminished resistance to passive stretching. Hypotonia is not the same as muscle weakness, although the two conditions can co-exist.
Microcephaly
MedGen UID:
1644158
Concept ID:
C4551563
Finding
Head circumference below 2 standard deviations below the mean for age and gender.
Lymphedema
MedGen UID:
6155
Concept ID:
C0024236
Disease or Syndrome
Localized fluid retention and tissue swelling caused by a compromised lymphatic system.
Prominent nasal bridge
MedGen UID:
343051
Concept ID:
C1854113
Finding
Anterior positioning of the nasal root in comparison to the usual positioning for age.
Sloping forehead
MedGen UID:
346640
Concept ID:
C1857679
Finding
Inclination of the anterior surface of the forehead from the vertical more than two standard deviations above the mean (objective); or apparently excessive posterior sloping of the forehead in a lateral view.

Recent clinical studies

Etiology

Natacci F, Bedeschi MF, Righini A, Inverardi F, Rizzuti T, Boschetto C, Triulzi F, Spreafico R, Frassoni C, Lalatta F
Prenat Diagn 2007 Jun;27(6):568-72. doi: 10.1002/pd.1728. PMID: 17367103
Dobyns WB, Stratton RF, Greenberg F
Am J Med Genet 1984 Jul;18(3):509-26. doi: 10.1002/ajmg.1320180320. PMID: 6476009

Diagnosis

Tosello B, Brévaut-Malaty V, Chaumoître K, Gire C
Fetal Pediatr Pathol 2015 Jun;34(3):197-201. Epub 2015 Apr 30 doi: 10.3109/15513815.2015.1031414. PMID: 25927602
Natacci F, Bedeschi MF, Righini A, Inverardi F, Rizzuti T, Boschetto C, Triulzi F, Spreafico R, Frassoni C, Lalatta F
Prenat Diagn 2007 Jun;27(6):568-72. doi: 10.1002/pd.1728. PMID: 17367103
Caksen H, Tuncer O, Kirimi E, Fryns JP, Uner A, Unal O, Cinal A, Odabaş D
Genet Couns 2004;15(1):9-17. PMID: 15083694
Sergi C, Zoubaa S, Schiesser M
Prenat Diagn 2000 Jun;20(6):505-9. PMID: 10861718
Iannetti P, Schwartz CE, Dietz-Band J, Light E, Timmerman J, Chessa L
Am J Med Genet 1993 Aug 1;47(1):95-9. doi: 10.1002/ajmg.1320470120. PMID: 8368261

Prognosis

Dobyns WB, Stratton RF, Greenberg F
Am J Med Genet 1984 Jul;18(3):509-26. doi: 10.1002/ajmg.1320180320. PMID: 6476009

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