Autism spectrum disorders in children and adolescents with Moebius sequence

Abstract

Moebius sequence is a rare congenital disorder usually defined as a combination of facial weakness with impairment of ocular abduction.

Congenital facial palsy and emotion processing: The case of Moebius syndrome

“…Because of facial and eye movement restriction, rates of autism and other mental disorders in people with MBS were previously overstated in the literature . Most patients present normal intelligence, while rare cases of autistic‐like behaviors (0%‐5%) and mild mental retardation (9%‐15%) have been reported . The syndrome is also referred to as Moebius “sequence,” term which defines a cascade of secondary events after an initial insult during the embryonic development, as well as a possible genetic etiology (see Box ).…”

Autisms

“…These two drugs display several interesting parallels: both hamper fetal blood perfusion either directly (thalidomide) or indirectly (misoprostol); both produce systemic and especially ophthalmologic malformations, primarily coloboma and microphtalmos (Miller et al, 2004(Miller et al, , 2005; both frequently cause prenatally exposed children to develop signs of Moebius sequence, including horizontal strabismus (Duane syndrome) and facial nerve palsy due to the involvement of the VI and VII cranial nerves (Bandim et al, 2003;Miller et al, 2005); both are associated with enhanced risk of autism and/or mental retardation, provided exposure occurs early in development (Miller et al, 2005;Strömland et al, 1994). Patients with idiopathic Moebius sequence and with no history of prenatal exposure to thalidomide or misoprostol have been found at enhanced risk of autism by some (Gillberg and Steffenburg, 1989), but not by others (Briegel et al, 2009). The critical period for misoprostol has not been defined with the same precision, but it is known that maximum fetal vulnerability occurs during the first 2 months of pregnancy, and possible 5-6 weeks after fertilization (i.e., 7-8 weeks since the last menstrual cycle) (Bandim et al, 2003).…”

Environmental Factors in the Aetiology of Autism – Lessons from Animals Prenatally Exposed to Valproic Acid

“…There are several congenital conditions originating from disruption of very early development with highly increased rate of autism including (1) Moebius sequence (Briegel et al, 2009); (2) the CHARGE association (Hartshorne et al, 2005); (3) Goldenhar syndrome (Johansson et al, 2007); (4) Duane syndrome (Miller et al, 2009); (5) Joubert syndrome (Ozonoff et al, 1999); (6) Cornelia de Lange syndrome (Moss et al, 2008); and (7) SmithLimli-Opitz syndrome (Sikora et al, 2006). These syndromes are different in many ways, but they all involve abnormal development in the embryonic period.…”