Outstretched Index Finger - A Pointer is Peculiar Behaviour Characteristic of Angelman Syndrome in Adults – A Case Series Study

Authors

  • Peter Martin Séguin-Clinic, Diakonie Kork, Germany

DOI:

https://doi.org/10.6000/2292-2598.2019.07.04.4

Keywords:

Angelman syndrome, behavioural phenotype, index finger.

Abstract

Objective: To describe a behavioural feature, the outstretched pointing (and shaking) index finger, as a clue to the clinical diagnosis of Angelman syndrome (AS) in adults.

Methods: A case series, consisting of 43 adult individuals with the clinical diagnosis of AS, approved by genetic testing is presented. In 16/43 patients the clinical diagnosis was made by the author, mostly due to behavioural signs, including the pointing gesture, which he had increasingly noticed as a behavioural key feature in his adult patients with AS.

Conclusion: Pointing with the outstretched index finger is a communicative gesture frequently seen in adult persons with AS. Its absence is most likely due to more limited motor and/or intellectual functions, in phenotypes caused by deletions of 15q11-13 respectively. It can be seen as a clinical sign that significantly contributes to the diagnosis in adulthood.

References

Williams CA, Driscoll DJ, Dalgi AI. Clinical and genetic aspects of Angelman Syndrome. Genet Med 2010; 12: 385-95. https://doi.org/10.1097/GIM.0b013e3181def138 DOI: https://doi.org/10.1097/GIM.0b013e3181def138

Angelman H. “Puppet” children. A report on three cases. Dev Med Child Neurol 1965; 7: 681-8. https://doi.org/10.1111/j.1469-8749.1965.tb07844.x DOI: https://doi.org/10.1111/j.1469-8749.1965.tb07844.x

Williams CA, Beaudet AL, Clayton-Smith J, KnollJH, Kyllerman M, Laan LA, Magenis RE, Moncla A, Schinzel AA, Summers JA, Wagstaff Jl. Angelman Syndrome 2005: updated consensus for diagnostic criteria. Am J Med Genet 2006; 140A: 413-8. https://doi.org/10.1002/ajmg.a.31074 DOI: https://doi.org/10.1002/ajmg.a.31074

Williams CA, Dagli A. Angelman Syndrome. In: Cassidy SB, Allanson JE (Eds.), Management of Genetic Syndromes. Wiley-Blackwell, Hoboken NJ, 2010; pp. 69-80. https://doi.org/10.1002/9780470893159.ch6 DOI: https://doi.org/10.1002/9780470893159.ch6

Buntinx IM, Hennekam CM, Oebele FB, Stroink H, Beuten J, Mangelschots K, Fryns PJ. Clinical profile of Angelman syndrome at different ages. Am J Med Genet 1996; 56: 176-83. https://doi.org/10.1002/ajmg.1320560213 DOI: https://doi.org/10.1002/ajmg.1320560213

Finucane BM, Konar D, Haas-Givler B, Kurtz MD, Scott CI. The spasmotic upper-body squeeze: A characteristic behavior in Smith-Magenis syndrome. Dev Med Child Neurol 1994; 36: 78-83. https://doi.org/10.1111/j.1469-8749.1994.tb11770.x DOI: https://doi.org/10.1111/j.1469-8749.1994.tb11770.x

Bonati MT, Russo S, Finelli P, Valsecchi MR, Cogliati F, Cavalleri F, Roberts W, Elia M, Larizza L. Evaluation of autism traits in Angelman syndrome: a resource to unfold autism genes. Neurogenetics 2007; 8: 169-78. https://doi.org/10.1007/s10048-007-0086-0 DOI: https://doi.org/10.1007/s10048-007-0086-0

Sahoo T, Peters SU, Madduri NS, Glaze DG, German JR, Bird LM, Barbieri-Welge R, Bichell TJ, Beaudet AL, Bacino CA. Microarray based comparative genomic hybridization testing in deletion bearing patients with Angelman syndrome: genotype-phenotype correlations. J Med Genet 2006; 43: 512-6. https://doi.org/10.1136/jmg.2005.036913 DOI: https://doi.org/10.1136/jmg.2005.036913

Peters SU, Goddard-Finegold J, Beaudet AL, Madduri N, Turcich M, Bacino CA. Cognitive and adaptive behavior profiles of children with Angelman syndrome. Am J Med Genet A 2004; 128: 110-113. https://doi.org/10.1002/ajmg.a.30065 DOI: https://doi.org/10.1002/ajmg.a.30065

Trillingsgaard A, Ostergaard JR. Autism in Angelman syndrome: an exploration of comorbidity. Autism 2004; 8: 163-74. https://doi.org/10.1177/1362361304042720 DOI: https://doi.org/10.1177/1362361304042720

Ponson L, Gomot M, Blanc R, Barthelemy C, Roux S, Munnich A, Romana S, Aguillon-Hernandez N, Malan V, Bonnet-Brilhault F. 22q13 deletion syndrome: communication disorder or autism? Evidence from a specific clinical and neurophysiological phenotype. Translational Psychiatry 2018; 8: 146. https://doi.org/10.1038/s41398-018-0212-9 DOI: https://doi.org/10.1038/s41398-018-0212-9

Kamp-Becker I, Albertowski K, Becker J, Ghahreman M, Langmann A, Mingebach T, Poustka L, Weber L, Schmidt H, Smidt J, Stehr T, Roessner V, Kucharczyk K, Wolff N, Stroth S. Diagnostic accuracy of the ADOS and ADOS-2 in clinical practice. Eur Child Adolesc Psychiatry 2018; 27: 1193-207. https://doi.org/10.1007/s00787-018-1143-y DOI: https://doi.org/10.1007/s00787-018-1143-y

Havdahl KA, Bal VH, Huerta M, Pickles A, Øyen AS, Stoltenberg C, Lord C, Bishop SL. Multidimensional influences on autism symptom measures: Implications for use in etiological research. J Am Acad Child Adolesc Psychiatry 2016; 55: 1054-63. https://doi.org/10.1016/j.jaac.2016.09.490 DOI: https://doi.org/10.1016/j.jaac.2016.09.490

Wheeler AC, Sacco P, Cabo R. Unmet clinical needs and burden in Angelman syndrome: a review of the literature. Orphanet J Rare Dis 2017; 12: 164. https://doi.org/10.1186/s13023-017-0716-z DOI: https://doi.org/10.1186/s13023-017-0716-z

Downloads

Published

2019-11-18

How to Cite

Martin, P. (2019). Outstretched Index Finger - A Pointer is Peculiar Behaviour Characteristic of Angelman Syndrome in Adults – A Case Series Study. Journal of Intellectual Disability - Diagnosis and Treatment, 7(4), 227–230. https://doi.org/10.6000/2292-2598.2019.07.04.4

Issue

Section

General Articles