Angelman syndrome (AS) is a distinct condition that presents with severe developmental delay. This condition also presents with speech impairment, ataxia/tremor, and inappropriate laughter. Some other features in most patients include microcephaly, seizures, tongue protrusion, wide mouth, and hypopigmentation. This case aims to emphasize the value of diagnosis in a patient with developmental delay. The diagnosis allows anticipation of the development of other possible problems and guides appropriate management. This report also aims to increase awareness regarding the condition. Here we present a 71-month-old Filipino male with developmental delay at six months, seizures at 10 months with a note of an overall happy demeanor and frequent inappropriate bouts of laughter at one year old. The patient also presented with severe stunting, microcephaly, wide mouth and ataxic gait. Through pattern recognition and the updated consensus of its diagnostic criteria, and confirmation via fluorescence in situ hybridization (FISH), which revealed a deletion in chromosome 15q11, the diagnosis of AS was made. This case re-emphasizes the role of clinical recognition of this condition and its confirmation via cytogenetic techniques like FISH, which will aid appropriate management and counseling for the patient and their families.
Angelman Syndrome

Humans ; Angelman Syndrome/therapy*

The rate of people with mental retardation was 1% of population. There were many causes of disease but there were the same properties of the diseases. There were differences of outcomes caused by patients with mental retardation such as disorder of social order and life threatening. It should manage and prevent bad behavior that can occur to reduce or exclude their responsibilities when committing the crime according the disease level
Mental Retardation ; Angelman Syndrome ; Forensic Medicine

Angelman syndrome is a rare genetic disorder characterized by developmental delay, speech impairment, ataxic gait, paroxysmal laughter, and seizures. The diagnosis is suspected in infants who have the characteristic clinical features and electroencephalographic (EEG) abnormalities, and is confirmed by the genetic identification of a maternally derived 15q11-13 deletion. We report a case of genetically confirmed Angelman syndrome who had the characteristic clinical and EEG features.
Angelman Syndrome* ; Chromosomes, Human, Pair 15 ; Diagnosis ; Electroencephalography ; Gait ; Humans ; Infant ; Language Development Disorders ; Laughter ; Seizures

Angelman syndrome (AS) is a rare, neurodevelopmental disorder caused by a variety of genetic abnormalities involving the chromosome 15q11-13 region. Clinical manifestations include severe psychomotor retardation, epilepsy, lack of speech, cerebellar ataxia, frequent bouts of laughing, morphological defect of the facial bones and sleep disturbance. The main anesthetic considerations in AS patients are significant dominance of vagal tone, profound disorders of GABA system with defects in its receptor function, epilepsy and peripheral muscular atrophy. We report the experience of anesthetic management for strabismus surgery in a patient with AS.
Anesthesia ; Angelman Syndrome ; Cerebellar Ataxia ; Epilepsy ; Facial Bones ; gamma-Aminobutyric Acid ; Humans ; Muscular Atrophy ; Strabismus

Angelman syndrome is a neurogenetic disorder which results from the loss of expression of a maternal imprinted gene, UBE3A, mapped within 15q11-q13 presenting with various neurodevelopmental problems. We report a 3 year-old-girl who had severe developmental delay, speech impairment, ataxic gait, jerky movement and recurrent seizures with abnormal EEG, characteristic pattern with high amplitude slow spike-and-wave discharge on the bifrontal region. The patient was genetically confirmed Angelman syndrome who had two episode of status epilepticus with cortical atrophic changes on her left hemisphere. Angelman syndrome should be suspected in differential diagnosis in infant who has severe speech and developmental delay, tremulous movement accompanied by cryptogenic seizure disorders including characteristic EEG features.
Angelman Syndrome* ; Atrophy* ; Diagnosis, Differential ; Electroencephalography ; Epilepsy ; Gait ; Humans ; Infant ; Language Development Disorders ; Seizures ; Status Epilepticus

OBJECTIVETo investigate the clinical manifestations and EEG characteristics of Angelman syndrome in children, and to strengthen the recognition of this disease.

METHODFourteen children with Angelman syndrome received video EEG monitoring, head MRI/CT and gene test, 11 patients received the metabolic investigations (e.g., lactic acid, ammonia, GC/MS and MS/MS). Eight patients received Gesell test. The patients were followed up for 1-3 years.

RESULTOf the 14 cases, 4 were male and 10 female, their age was from 8 months to 3 years and 7 months. The clinical characteristics included prominent lower jaw and wide mouth, fair skin and yellow hair, light-colored iris, paroxysmal laughter, astasia and language backward. Twelve patients had epileptic seizures; 10 patients displayed non-convulsive status epilepticus (NCSE), 9 patients displayed myoclonic, atypical absence, and non-convulsive seizure simultaneously; myoclonic, generalized tonic-clonic seizure and complex partial seizure in 1 each; 4 patients had fever in early seizures. The EEG showed paroxysmal middle-high amplitude 2-3 Hz spike and spinous slow-wave in 8 patients. Four patients showed paroxysmal frequently middle-high amplitude 2-3 Hz slow waves mixed with sharps. The other 2 patients showed a normal EEG. All the patients were diagnosed with genetics testing. The results included maternal deletion of chromosome 15q11-13 in 12, paternal uniparental disomy in 1 and imprinting defects in 1.

CONCLUSIONThere are characteristic clinical manifestation and craniofacial features in Angelman syndrome patients. Some patients have specific EEG patterns. Abnormal region of chromosome 15q11-13 is the basis of diagnosis.

Angelman Syndrome ; diagnosis ; genetics ; physiopathology ; Child, Preschool ; Electroencephalography ; Female ; Humans ; Infant ; Male

OBJECTIVETo explore the genetic cause for two familial Angelman syndrome cases and correlation between the clinical phenotypes and their genetic basis.

METHODSKaryotyping analysis and microarray assay were carried out to exclude chromosome anomalies and uniparental disomy. The UBE3A gene was analyzed for potential point mutations, deletions, insertions and splice site mutations. Reverse transcription PCR was used to evaluate splicing mutation of the RNA transcripts.

RESULTSDNA sequencing showed the proband of family 1 has carried a novel maternal UBE3A splice acceptor site mutation, resulting in a guanine-to-cytosine transversion (IVS15-1G>C). Reverse transcription PCR revealed the proband and his mother both carried heterozygous mutant transcripts with loss of 54 and 59 nucleotides in exon 16, respectively. The proband displayed severe mental retardation, ataxia, seizures and inappropriate laughter. The siblings of family 2 has carried a novel maternal missense mutation in exon 16 of the UBE3A gene (c.2540C>T). She also presented with mental retardation, absent speech, mild ataxia and inappropriate laughter.

CONCLUSIONThe novel IVS15-1G>C and c.2540 C>T mutations of the UBE3A gene probably underlie the AS in the two families. Compared with small-scale mutations, larger fragments mutations can produce more severe phenotypes.

Angelman Syndrome ; genetics ; Female ; Humans ; Karyotyping ; Male ; Mutation ; Ubiquitin-Protein Ligases ; genetics

OBJECTIVETo analyze a case with Angelman syndrome (AS) using single nucleotide polymorphism array (SNP array) and explore its genotype-phenotype correlation.

METHODSG-banded karyotyping and SNP array were performed on a child featuring congenital malformations, intellectual disability and developmental delay. Mendelian error checking based on the SNP information was used to delineate the parental origin of detected abnormality. Result of the SNP array was validated with fluorescence in situ hybridization (FISH).

RESULTSThe SNP array has detected a 6.053 Mb deletion at 15q11.2q13.1 (22,770,421- 28,823,722) which overlapped with the critical region of AS (type 1). The parents of the child showed no abnormal results for G-banded karyotyping, SNP array and FISH analysis, indicating a de novo origin of the deletion. Mendelian error checking based on the SNP information suggested that the 15q11.2q13.1 deletion was of maternal origin.

CONCLUSIONSNP array can accurately define the size, location and parental origin of chromosomal microdeletions, which may facilitate the diagnosis of AS due to 15q11q13 deletion and better understanding of its genotype-phenotype correlation.

Angelman Syndrome ; genetics ; Child ; Genotype ; Humans ; Karyotyping ; methods ; Male ; Phenotype ; Polymorphism, Single Nucleotide ; genetics

OBJECTIVE: To explore the genetic etiology for a Chinese pedigree affected with Angelman syndrome (AS). METHODS: The proband with phenotypes suggestive of AS was subjected to copy number variation sequencing (CNV-seq), methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) and high-throughput next generation sequencing (NGS). Variant of the UBE3A gene was verified among family members by Sanger sequencing and bioinformatic analysis. RESULTS: NGS revealed that the proband has carried a heterozygous variant of the UBE3A gene, namely c.1517G>A (p.R506H). The variant has co-segregated with the disease in the pedigree. Multiple amino acid sequence alignment showed that the site of mutant residue is conserved among nine homologous species. The variant was predicted to be deleterious by bioinformatic analysis. CONCLUSION A novel variant of the UBE3A gene has been identified in a Chinese pedigree affected with AS. Above finding has further expanded the spectrum of UBE3A gene variants and phenotypes of AS, which also facilitated molecular diagnosis and genetic counseling for the family.
Angelman Syndrome/genetics* ; China ; DNA Copy Number Variations ; Humans ; Mutation ; Pedigree ; Phenotype