PubMed · 6680160
The author defines lacunes, classifies types of lacunes and their causes, discusses the correlation between lacunes and specific syndromes, and suggests appropriate therapy.
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J P Mohr. 1983. Lacunes.. https://pubmed.ncbi.nlm.nih.gov/6680160/
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Five boys and two girls from a large consanguineous British Muslim family of Pakistani origin are described. All presented from infancy to early childhood with progressive moderate to severe developmental delay, postnatal microcephaly, spastic quadriplegia, refractory seizures, and visual handicap. Cerebrospinal fluid (CSF) pleocytosis was present in three children. Neuroimaging with computerized tomography on three boys and a girl showed generalized cortical atrophy, dilatation of the lateral, third, and fourth ventricles, widening of the surface CSF spaces, hypoplasia of the posterior fossa structures, and multiple and solitary calcifications in the cerebral cortex and punctate calcifications involving basal ganglia, cerebellum, and the Sylvian fissure. Histopathological examination of the brain from three boys and one girl confirmed generalized cortical and cerebellar atrophy with widespread calcifications within the cortical grey and white matter, the basal ganglia, the cerebellum, and in some areas along the capillaries. Investigations excluded a possible nongenetic cause. Parental consanguinity favor autosomal recessive inheritance. This appears to be a recognizable syndrome overlapping the syndrome of Aicardi and Goutières (MIM 225750).
Idiopathic cerebral calcification can be associated with a progressive neurologic disorder for which there is no known treatment. This report describes a patient with a familial form of this disorder presenting in middle age with progressive Parkinson-like features along with spasticity, dystonia, and ataxia. Disodium etidronate, a bisphosphonate, produced a two-fold improvement in the rate of his speech and gait, but did not affect his spasticity, dystonia, or ataxia. Quantitative analysis of cerebral calcification did not reveal any reduction in the amount of calcification, suggesting other possible mechanisms for this clinical improvement.
Aicardi-Goutières syndrome is characterized by the calcification of basal ganglia, leukodystrophy, and lymphocytosis in cerebrospinal fluid. No brainstem lesion has been described. We report a Japanese girl who presented with delayed development and microcephalus at early infancy. Magnetic resonance imaging revealed T2-weighted high intensity in the cerebral white matter and brainstem, and nerve conduction velocity was delayed in the central nervous system, indicating that she manifested dysmyelination in the brainstem white matter similar to that in the cerebral white matter.