Ring chromosome 20 syndrome: A link between epilepsy onset and neuropsychological impairment in three children
Aglaia Vignoli
Epilepsy Centre, San Paolo Hospital, University of Milan, Milan, Italy
Search for more papers by this authorMario Paola Canevini
Epilepsy Centre, San Paolo Hospital, University of Milan, Milan, Italy
Search for more papers by this authorFrancesca Darra
Child Neuropsychiatry Unit, University of Verona, Verona, Italy
Search for more papers by this authorLorita La Selva
Pediatric Epilepsy Service, San Paolo Hospital, Bari, Italy
Search for more papers by this authorElena Fiorini
Child Neuropsychiatry Unit, University of Verona, Verona, Italy
Search for more papers by this authorAda Piazzini
Epilepsy Centre, San Paolo Hospital, University of Milan, Milan, Italy
Search for more papers by this authorFrancesca Lazzarotto
Child Neuropsychiatry Unit, University of Verona, Verona, Italy
Search for more papers by this authorClaudio Zucca
“La Nostra Famiglia” Institute–Bosisio Parini, Lecco, Italy
Search for more papers by this authorBernardo Dalla Bernardina
Child Neuropsychiatry Unit, University of Verona, Verona, Italy
Search for more papers by this authorAglaia Vignoli
Epilepsy Centre, San Paolo Hospital, University of Milan, Milan, Italy
Search for more papers by this authorMario Paola Canevini
Epilepsy Centre, San Paolo Hospital, University of Milan, Milan, Italy
Search for more papers by this authorFrancesca Darra
Child Neuropsychiatry Unit, University of Verona, Verona, Italy
Search for more papers by this authorLorita La Selva
Pediatric Epilepsy Service, San Paolo Hospital, Bari, Italy
Search for more papers by this authorElena Fiorini
Child Neuropsychiatry Unit, University of Verona, Verona, Italy
Search for more papers by this authorAda Piazzini
Epilepsy Centre, San Paolo Hospital, University of Milan, Milan, Italy
Search for more papers by this authorFrancesca Lazzarotto
Child Neuropsychiatry Unit, University of Verona, Verona, Italy
Search for more papers by this authorClaudio Zucca
“La Nostra Famiglia” Institute–Bosisio Parini, Lecco, Italy
Search for more papers by this authorBernardo Dalla Bernardina
Child Neuropsychiatry Unit, University of Verona, Verona, Italy
Search for more papers by this authorSummary
Purpose: Ring chromosome 20 [r(20)] syndrome is a well-defined chromosomal disorder characterized by epilepsy, mild-to-moderate mental retardation, and lack of recognizable dysmorphic features. Epilepsy is often the most important clinical manifestation of the syndrome, even if its appearance is not constantly precocious. Seizures are frequently drug resistant.
Methods: We describe three children with [r(20)] syndrome in whom the onset of epilepsy (age at onset range: 4 years and 6 months to 9 years and 4 months) determined a kind of epileptic status (age at onset range: 6 years and 10 months to 9 years and 8 months) with dramatic neuropsychological deterioration. This epileptic status lasted for several months because of refractoriness to most antiepileptic drugs (AEDs), but it was treated successfully with a combination of valproate and lamotrigine in two children.
Results: As soon as seizures stopped, the children showed prompt recovery with partial restoration of the neuropsychological impairment.
Conclusion: This clinical picture can be described as abrupt epileptic encephalopathy.
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