Abstract
Spastic diplegia, a muscle hypertonia motor syndrome, can occur in conjunction with
the characteristic abnormal movement features of Angelman syndrome (AS), a neurodevelopmental
disorder with primary features of ataxic gait, happy demeanor, developmental delay,
speech impairment, intellectual disability, microcephaly, and seizures. Spastic diplegia
is classically associated with cerebral palsy (CP), an umbrella term encompassing
developmental delay, abnormal brain magnetic resonance imaging findings, and various
types of CP including spastic, ataxic, dyskinetic, and mixed types. We present a 12-year-old
Haitian patient of African descent with AS due to a microdeletion involving the entire
UBE3A (ubiquitin-protein ligase E3A) gene and spastic diplegia. She was initially given
a clinical diagnosis of CP. Cases of AS in patients of African descent have been rarely
reported and this case of severe spastic diplegia, unresponsive to medical intervention,
reflects a rarely reported presentation of AS in patients of African descent and possibly
the first reported case of a Haitian patient with this clinical presentation. Given
that deletions are the most common mechanism resulting in AS, this case report provides
supportive evidence that chromosome 15q11 deletion-type AS is most frequently associated
with spastic diplegia, a more severe motor impairment phenotype in AS.
Keywords
Angelman syndrome -
UBE3A
- spastic diplegia