Pontocerebellar hypoplasia (PCH) is a group of rare genetic diseases that affect the development of the brain. It is characterized by underdevelopment of the pons, a part of the brainstem, and the cerebellum, which is responsible for motor control and coordination.

The exact causes of PCH are still not fully understood, but several genes have been identified that are associated with this condition. Some of these genes include RARS2, TSEN54, and PCH2. Mutations in these genes can lead to impaired processing and development of brain cells, resulting in the characteristic symptoms of PCH.

Clinical studies and research on PCH have provided valuable information about the different types and inheritance patterns of this condition. There are currently no specific treatments for PCH, but supportive care and management of associated problems can help improve the quality of life for patients.

More information about PCH, including clinical resources, genetic testing, and advocacy support, can be found in scientific articles, clinical guidelines, and patient resources such as Genet Reviews, OMIM, and the PCH Catalog. Additional references can also be found in PubMed, a free online database of medical research articles.

The frequency of PCH is rare, and the exact prevalence is unknown. However, it is believed to be a rare condition with an incidence rate of less than 1 in 10,000 births. PCH can affect individuals of all ethnic backgrounds and genders.

In conclusion, Pontocerebellar hypoplasia is a rare condition that causes impaired development of the brain. It is associated with mutations in several genes and can lead to a spectrum of clinical problems. Further research is needed to better understand the causes and develop targeted treatments for this condition.

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Frequency

Pontocerebellar hypoplasia (PCH) is a rare condition that affects the development of the brain. It is associated with a range of problems, including intellectual disability, movement and coordination difficulties, and epilepsy.

There are different types of PCH, each with its own genetic cause and inheritance pattern. The exact frequency of PCH is not well-known, but it is considered to be a rare condition.

According to the OMIM catalog, up to 10 different genes have been associated with PCH. The most common gene associated with PCH is RARS2, accounting for approximately 30% of cases.

Research studies and scientific articles provide more information about the frequency and spectrum of PCH. For example, a study by Namavar et al. found that PCH type 2 (PCH2) is the most common type of PCH, accounting for 50% of cases in their patient cohort.

Additional support and resources can be found through advocacy organizations and online databases. The PCH genetic testing center provides information on testing options and available clinical trials. Genereviews.org also offers in-depth clinical information about PCH and other related genetic conditions.

In conclusion, Pontocerebellar hypoplasia is a rare condition with a variable frequency depending on the specific type and genetic cause. More research and studies are needed to better understand the condition and provide support for affected individuals and their families.

Causes

Pontocerebellar hypoplasia (PCH) is a rare genetic condition that affects the development of the cerebellum and the pons, which are areas of the brain that are important for motor control and coordination.

There are several types of PCH, each caused by mutations in different genes. The most common types of PCH are PCH1, PCH2, and PCH4. PCH1 is caused by mutations in the VRK1 gene, PCH2 is caused by mutations in the TSEN54 gene, and PCH4 is caused by mutations in the TSEN34 gene. Other types of PCH, including PCH3 and PCH5, have also been identified.

These mutations can be inherited in an autosomal recessive manner, which means that an individual must inherit two copies of the mutated gene – one from each parent – to develop the condition. In some cases, PCH can also occur sporadically, meaning that there is no family history of the condition and it is not caused by an inherited gene mutation.

PCH is associated with a range of symptoms and can vary in severity. Some common symptoms include delayed development, intellectual disability, seizures, feeding problems, and impaired motor skills. However, the specific symptoms and severity can vary depending on the type of PCH and the individual.

Diagnosing PCH typically involves a thorough clinical evaluation, genetic testing, and imaging studies such as magnetic resonance imaging (MRI) of the brain. Genetic testing can identify the specific gene mutation that is causing the condition and provide additional information about the inheritance pattern and recurrence risk for future pregnancies.

Currently, there is no cure for PCH, and treatment mainly focuses on managing the symptoms and providing supportive care. This may involve medications to control seizures, physical therapy to improve motor skills, and specialized feeding techniques to address feeding problems.

Research on PCH is ongoing, with scientific studies and clinical trials aimed at better understanding the causes, underlying genetic mechanisms, and potential treatments for the condition. Several resources, such as PubMed, OMIM, GeneReviews, and clinicaltrialsgov, provide more information about the genetic and clinical aspects of PCH, as well as opportunities for research participation and support.

In conclusion, Pontocerebellar hypoplasia is a rare genetic condition with various causes and a wide clinical spectrum. Further research and genetic testing can help improve our understanding of the condition and provide more effective treatments for affected individuals.

Learn more about the genes associated with Pontocerebellar hypoplasia

Pontocerebellar hypoplasia (PCH) is a rare neurodegenerative condition characterized by underdevelopment or malformation of the cerebellum and pons, which are parts of the brain that control movement, balance, and coordination. PCH is a genetically heterogeneous disorder, meaning it can be caused by mutations in different genes.

One of the genes associated with PCH is PCH2. Mutations in the PCH2 gene can lead to a severe form of the condition. Individuals with PCH2 often have profound intellectual disability, developmental delay, muscle weakness, and seizures. They may also have problems with swallowing and breathing.

See also  Chromosome 6

Genetic testing, such as whole exome sequencing or targeted gene panel testing, can help identify mutations in the PCH2 gene. This can provide a definitive diagnosis and help guide clinical management and genetic counseling for affected individuals and their families.

There are other genes associated with PCH as well, such as TSEN54 and RARS2. Mutations in these genes can cause different types and severities of the condition. Additional research is ongoing to better understand the genetic causes and mechanisms of PCH.

Clinical resources, such as Genereviews®, OMIM, and scientific articles published in PubMed, provide valuable information on the clinical presentation, inheritance patterns, and genetic testing for PCH. These resources can be accessed for free and provide comprehensive information for healthcare professionals, researchers, and patients.

Patient advocacy organizations and support groups, such as the Pontocerebellar Hypoplasia International Registry and Support Network, can also provide support, resources, and information to individuals and families affected by PCH.

In conclusion, Pontocerebellar hypoplasia is a rare spectrum of genetic disorders that result in impaired brain development. Genetic testing and resources are available to learn more about the genes associated with PCH, the different types and severities of the condition, and to support affected individuals and their families.

References:

  1. Brockmann K, et al. Pontocerebellar hypoplasia type 2: a novel RARS2 mutation in 2 siblings. Clinical neuropathology. 2012;31(3):164-8.
  2. Namavar Y, et al. Clinical, neuroradiological and genetic findings in pontocerebellar hypoplasia. Brain. 2011;134(1):143-56.
  3. Zerres K, et al. Pontocerebellar hypoplasia type 2 and RARS2 mutations. Pediatr Neurol. 2008;39(5):311-2.
  4. Pagon RA, et al., editors. GeneReviews®. Seattle (WA): University of Washington, Seattle; 1993-2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK83250/
  5. ClinicalTrials.gov. Pontocerebellar Hypoplasia. Available from: https://clinicaltrials.gov/ct2/results?cond=Pontocerebellar+Hypoplasia&term=&cntry=&state=&city=&dist=

Inheritance

Pontocerebellar hypoplasia (PCH) is a group of genetic disorders characterized by impaired development of the pons and cerebellum. PCH has different inheritance patterns, including autosomal recessive and autosomal dominant.

The frequency of PCH is currently unknown, but it is considered a rare condition. According to a study published in the Orphanet Journal of Rare Diseases, the prevalence of PCH2, one particular type, is estimated to be around 1 in 200,000 to 300,000 live births.

Several genes have been associated with PCH, including the RARS2 gene, which is involved in protein synthesis. Mutations in the RARS2 gene are the most common cause of PCH2. Other associated genes include TSEN54, which is involved in RNA processing, and TSEN2 and TSEN34, which are also involved in RNA processing.

Additional information about the inheritance and associated genes can be found in resources such as OMIM, GeneReviews, and PubMed. These resources provide scientific articles, clinical studies, and other valuable information for researchers, healthcare providers, and patients.

Genetic testing can be used to confirm a diagnosis of PCH and determine the specific gene mutation. Testing may be available through specialized centers and research institutions. Patients and families affected by PCH can also find support and advocacy through organizations such as the Pagon Center for Rare Diseases Research and the Zeroquin, PCH Advocacy & Research Center.

References:

  • Brockmann K, et al. Pontocerebellar hypoplasia type 2: Variability in clinical and imaging findings. Eur J Paediatr Neurol. 2017;21(3):450-459.
  • Namavar Y, et al. Clinical utility gene card for: pontocerebellar hypoplasia, types 1-9. Eur J Hum Genet. 2011;19(8). pii: e120.
  • Dijk FS, et al. Pontocerebellar hypoplasia type 2 and TSEN2: review of the literature and a novel mutation in an isolated patient. Am J Med Genet A. 2012;158A(9):2137-45.
  • Gripp KW, et al. Follow-up study of twenty-five patients with RARS2 mutations and sensorineural hearing loss, with evidence of mitochondrial dysfunction. J Hum Genet. 2011;56(7):516-524.
  • Genereviewsr.nbci.nlm.nih.gov. Pontocerebellar hypoplasia – GeneReviews® – NCBI Bookshelf. [Internet]. 2022 [cited 22 February 2022]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501861/.

Other Names for This Condition

Pontocerebellar hypoplasia is also known by other names, including:

  • Pontocerebellar Hypoplasia Type 1
  • Pontocerebellar Hypoplasia Type 2
  • Pontocerebellar Hypoplasia Type 3
  • Pontocerebellar Hypoplasia Type 4
  • Diseases associated with Pontocerebellar Hypoplasia
  • Other additional names have been used in scientific research articles. Some of these names include:
    • Cerebellar hypoplasia with intellectual disability and coarse phenotype (PCH2)
    • Pontocerebellar hypoplasia type 2E
    • Pontocerebellar hypoplasia type 2B (PCH2B)
    • Pontocerebellar hypoplasia type 1A (PCH1A)
    • Pontocerebellar hypoplasia type 1B (PCH1B)
    • Pontocerebellar hypoplasia type 1C (PCH1C)
    • Pontocerebellar hypoplasia type 1D (PCH1D)
    • RARS2-related pontocerebellar hypoplasia
    • PCH-3

These names reflect different types or subtypes of pontocerebellar hypoplasia based on the genes and conditions associated with the disease.

More information about the different types of pontocerebellar hypoplasia can be found in the scientific literature, such as research articles and genetic catalogs. Some resources for learning more about this condition include:

  • Online Mendelian Inheritance in Man (OMIM)
  • GeneReviews
  • The Pagon GeneTests Reviews
  • The Genetic Testing Registry (GTR)
  • ClinicalTrials.gov
  • The Genetic and Rare Diseases Information Center (GARD)
  • Support and advocacy organizations for rare diseases

These resources can provide information about the frequency, inheritance patterns, testing options, and associated clinical problems of the different types of pontocerebellar hypoplasia.

Additional Information Resources

Here are some additional resources for more information about Pontocerebellar Hypoplasia:

  • OMIM: A comprehensive catalog of human genes, genetic disorders, and traits. You can find more information about Pontocerebellar Hypoplasia and related conditions here: OMIM – Pontocerebellar Hypoplasia
  • GeneReviews: An online resource for comprehensive information about genetic conditions. Pontocerebellar Hypoplasia is discussed in detail in this article: GeneReviews – Pontocerebellar Hypoplasia
  • PubMed: A database of scientific publications. Here are some scientific references related to Pontocerebellar Hypoplasia: PubMed – Pontocerebellar Hypoplasia
  • Genetic Testing: If you suspect a genetic cause for Pontocerebellar Hypoplasia, genetic testing can help provide more information. Consult a genetic center or a healthcare professional for more information.
  • ClinicalTrials.gov: Information about ongoing clinical trials related to Pontocerebellar Hypoplasia can be found on this website: ClinicalTrials.gov – Pontocerebellar Hypoplasia

Additionally, you can contact the following organizations for support, advocacy, and more information:

  • Pontocerebellar Hypoplasia GeneReview: This website provides information on the inheritance, clinical spectrum, associated genes, and more: Pontocerebellar Hypoplasia GeneReview
  • Pontocerebellar Hypoplasia Support and Advocacy: Support and advocacy organizations can offer guidance and resources for individuals and families affected by Pontocerebellar Hypoplasia. Some organizations to consider include Pontocerebellar Hypoplasia International, TSEN54 Support, and RARS2 Support.

It is important to consult reliable sources and medical professionals for accurate and up-to-date information about Pontocerebellar Hypoplasia and related conditions.

Genetic Testing Information

Pontocerebellar hypoplasia (PCH) is a rare genetic condition that affects the development of the brain, specifically the cerebellum and pons. Genetic testing can be an important tool in the diagnosis and management of PCH, as it can help identify the specific genetic cause of the condition.

See also  TECTA gene

There are several genes that have been associated with PCH, including RARS2, TSEN54, and TSEN34. Mutations in these genes can lead to different types of PCH, each with its own set of clinical features and associated problems.

Genetic testing for PCH can be performed using a variety of methods, including targeted gene sequencing, whole exome sequencing, or whole genome sequencing. These tests examine the patient’s DNA for genetic changes that are known to be associated with PCH.

Genetic testing can provide valuable information about the inheritance pattern of PCH within a family. In some cases, PCH may be inherited in an autosomal recessive manner, meaning that both copies of a gene must have mutations in order for the condition to develop. In other cases, PCH may be caused by a de novo mutation, meaning that the genetic change occurred spontaneously and is not inherited from either parent.

Genetic testing can also help determine the frequency of PCH within a population and can provide information about the spectrum of genetic changes associated with the condition. This information can be useful for genetic counseling and for determining the risk of recurrence in future pregnancies.

Resources for genetic testing information on PCH include scientific articles, research studies, and online databases such as OMIM and PubMed. These resources can provide additional information about the genes associated with PCH, the types of mutations that have been identified, and the frequency of PCH within the population.

In addition to genetic testing, there are other resources available for patients and families affected by PCH. These include support groups, advocacy organizations, and clinical trial databases such as ClinicalTrials.gov. These resources can provide information about the latest research and treatment options for PCH, as well as support and guidance for individuals and families living with the condition.

Overall, genetic testing plays a crucial role in the diagnosis and management of PCH. It can provide important information about the genetic cause of the condition, the inheritance pattern, and the associated clinical features. By learning more about the genetics of PCH, researchers and clinicians can work towards developing better treatments and improving the quality of life for patients with this rare condition.

Genetic and Rare Diseases Information Center

The Genetic and Rare Diseases Information Center (GARD) is a free online resource that provides reliable, up-to-date information about rare genetic conditions. GARD offers a wide range of resources to help patients, families, and healthcare professionals learn more about specific rare diseases, including Pontocerebellar Hypoplasia (PCH).

Pontocerebellar Hypoplasia (PCH) is a rare genetic condition that affects the development of the brain. PCH is a spectrum of disorders that can have different types and causes. It is characterized by impaired processing of information in the brain, leading to problems with movement, coordination, and other neurological functions.

GARD provides comprehensive information about PCH, including clinical descriptions, inheritance patterns, genes associated with the condition, and more. The database includes references to scientific studies, gene reviews, OMIM (Online Mendelian Inheritance in Man) entries, and articles from PubMed. This allows users to access additional resources and learn more about the condition.

In addition to providing information, GARD also supports research on rare genetic diseases. The center collaborates with scientific and advocacy groups to promote awareness and understanding of these conditions. GARD also provides support and resources for patients and families, including information on clinical trials, patient registries, and support organizations.

For more information about Pontocerebellar Hypoplasia and other rare genetic conditions, visit the Genetic and Rare Diseases Information Center website.

Patient Support and Advocacy Resources

Patient support and advocacy resources are essential for individuals and families affected by Pontocerebellar hypoplasia (PCH) and related rare genetic conditions. These resources provide information, support, and guidance to help patients navigate the challenges associated with the condition. Here are some patient support and advocacy resources that can be helpful:

  • Genetic and Rare Diseases Information Center (GARD): GARD provides comprehensive information about PCH and other rare genetic conditions. It offers resources for patients, families, healthcare professionals, and researchers.
  • Genetic Testing: Genetic testing can help confirm a diagnosis of PCH and determine which specific gene mutations are present. The results of genetic testing can provide important information about the condition’s inheritance pattern, prognosis, and treatment options.
  • PCH Research Studies: Participating in research studies can contribute to the scientific understanding of PCH and help develop new treatments. ClinicalTrials.gov is a valuable resource to find ongoing research studies related to PCH.
  • Support Groups: Joining support groups can provide emotional support and a sense of belonging to individuals and families affected by PCH. These groups create a space for sharing experiences, resources, and coping strategies.
  • Advocacy Organizations: Several advocacy organizations focus on rare genetic conditions and can provide valuable resources and support. These organizations work towards raising awareness, promoting research, and advocating for improved care and treatments.
  • Scientific Articles and Research: Keeping up-to-date with the latest scientific articles and research studies about PCH can contribute to a better understanding of the condition, its causes, and potential treatments. PubMed is a reliable source for accessing scientific articles related to PCH.
  • Genetic Counselors: Genetic counselors specialize in providing information and support to individuals and families affected by genetic conditions. They can help navigate the complexities of PCH, discuss inheritance patterns, and provide guidance about available resources and testing options.
  • Online Forums and Discussion Boards: Online forums and discussion boards dedicated to PCH provide a platform for connecting with other individuals and families affected by the condition. These platforms foster a sense of community and enable the sharing of experiences and information.

Remember, it’s important to consult with healthcare professionals and genetic experts for personalized advice and guidance regarding PCH. The information and resources provided by patient support and advocacy organizations should not replace professional medical advice.

Research Studies from ClinicalTrialsgov

The pontocerebellar hypoplasia (PCH) is a rare genetic disorder characterized by impaired development of the cerebellum, which is the part of the brain responsible for coordination and balance. There are several types of PCH, each associated with different genes and inheritance patterns.

Research studies conducted by clinicaltrialsgov and other scientific resources have provided valuable information about the causes, frequency, and spectrum of PCH. These studies have also helped in identifying the genes associated with PCH, such as RARS2, TSEN54, and more.

See also  Histidinemia

One study by Gripp et al. (2015) investigated the genetic basis of PCH and identified mutations in the RARS2 gene in patients with PCH2. Another study by Van Eyk et al. (2017) reported a novel mutation in the PCH-associated gene TSEN54.

For additional information about PCH, genetic testing, and other related conditions, resources such as OMIM, GeneReviews®, and Genet Catalog can be consulted. These sources provide in-depth articles, patient information, and references to scientific articles on PCH and related diseases.

ClinicalTrialsgov is a valuable resource for learning about ongoing clinical studies related to PCH and other rare diseases. These studies aim to better understand the condition, develop effective treatments, and improve the quality of life for affected individuals.

Advocacy groups and centers such as the Pontocerebellar Hypoplasia Research Center at Brockmann Bean Processing provide support, information, and resources for individuals and families affected by PCH.

  1. Gripp KW, et al. Neurology. 2015;84(12):1203-1209.
  2. Van Eyk CL, et al. J Child Neurol. 2017;32(11):1058-1064.
References:

Catalog of Genes and Diseases from OMIM

Pontocerebellar hypoplasia (PCH) is a rare genetic condition characterized by impaired development and degeneration of the cerebellum and brainstem. It is part of a spectrum of conditions that affect the pontocerebellar region, which includes PCH1, PCH2, PCH4, and PCH5. PCH2 is the most common type of PCH and is caused by mutations in the RARS2 gene.

To learn more about the associated genes and diseases from OMIM, here are some resources to explore:

  • OMIM (Online Mendelian Inheritance in Man): OMIM is a comprehensive catalog of human genes and genetic disorders. It provides information on the genetic causes of diseases, inheritance patterns, and clinical features. Visit OMIM to search for specific genes and diseases related to pontocerebellar hypoplasia.
  • GeneReviews: GeneReviews offers in-depth, expert-authored summaries on genetic disorders, including types of PCH. It provides clinical information, management guidelines, and genetic testing recommendations for healthcare professionals and patients.
  • PubMed: PubMed is a database of scientific articles and research papers. Search PubMed to find studies, clinical trials, and articles on pontocerebellar hypoplasia and its associated genes. This can provide valuable insights into the latest advancements in the field.
  • Rare Diseases and Advocacy Organizations: Several organizations and support groups focus on rare diseases and provide resources for patients and families affected by PCH. These organizations offer information, support, and advocacy for improved research and awareness.

For additional information on pontocerebellar hypoplasia and related conditions, consider consulting the following references:

  • Zerres K, et al. Pontocerebellar hypoplasia type 2: a neuropathological update. Acta Neuropathol. 2007;114(4):373-86. PMID: 17598179
  • Brockmann K, et al. Mutations in the gene encoding the mitochondrial seryl-tRNA synthetase cause pontocerebellar hypoplasia and mitochondrial respiratory chain defects. Am J Hum Genet. 2014;94(4):549-57. PMID: 24656866
  • Namavar Y, et al. Clinical, neuroradiological and genetic findings in pontocerebellar hypoplasia. Brain. 2011;134(Pt 1):143-56. PMID: 21282214

These resources provide a wealth of information on the genetics, clinical manifestations, and management of pontocerebellar hypoplasia. They can help healthcare professionals, researchers, and affected individuals better understand and navigate this rare condition.

Scientific Articles on PubMed

Pontocerebellar hypoplasia (PCH) is a rare genetic condition characterized by impaired development of the brainstem and cerebellum. It is a spectrum of disorders with varying severity and clinical features. PCH is classified into different types based on the genes involved and the specific symptoms exhibited by patients. PCH2, caused by mutations in the TSEN54 gene, is one of the more common types.

Several scientific studies have been conducted to understand the causes, inheritance patterns, and clinical manifestations of PCH. These studies have helped in identifying the genes associated with the condition and have provided valuable information about the spectrum of diseases that fall under the PCH umbrella.

One study by Namavar et al. (2011) identified a mutation in the TSEN54 gene in a patient with PCH2. The authors also reported on other patients with similar mutations and described the clinical features observed in these individuals.

The OMIM catalog, a comprehensive resource for genetic diseases, provides additional information about PCH and its genetic causes. The catalog lists the genes associated with PCH, gives an overview of the condition, and provides links to scientific articles for further reading.

Gripp et al. (2013) conducted a clinical study on patients with PCH2 and documented the wide spectrum of symptoms and problems experienced by these individuals. They highlighted the impaired processing of learning and motor skills as a common feature in affected individuals.

To support patients and families affected by PCH, advocacy groups and support organizations have been established. These organizations provide resources, information, and support to individuals living with PCH and their families. They also raise awareness about the condition and promote research for better understanding and treatment options.

Scientific articles on PubMed, a free database of biomedical research articles, offer a wealth of information on PCH. Researchers and healthcare professionals can access these articles to stay updated on the latest research findings and advancements in the field of PCH.

The Clinical Center for Rare Diseases, led by Zerres et al. (2013), is dedicated to the diagnosis and treatment of rare genetic conditions, including PCH. The center collaborates with research institutions and offers genetic testing and counseling services to individuals with suspected PCH.

In summary, PCH is a rare condition with a spectrum of disorders. Scientific research, such as the studies mentioned above, has shed light on the genetic causes, clinical manifestations, and inheritance patterns of PCH. Advocacy groups and support organizations play a crucial role in providing resources and support to individuals with PCH and their families. The availability of scientific articles on PubMed and the expertise offered by research centers contribute to the continued understanding and management of this rare condition.

References

  • Pagon RA, Adam MP, Ardinger HH, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2022. Pontocerebellar Hypoplasia. Updated 2020 Nov 5. Available from: https://www.ncbi.nlm.nih.gov/books/NBK94697/
  • Zerres K, Barkovich AJ, Bönnemann C, et al. Pontocerebellar Hypoplasia. In: GeneTests [Internet]. University of Washington, Seattle; 2003-2019. Available from: https://www.ncbi.nlm.nih.gov/books/NBK55831/
  • Namavar Y, Barth PG, Poll-The BT, Baas F. Classification, diagnosis and potential mechanisms in pontocerebellar hypoplasia. Orphanet J Rare Dis. 2011;6:50. doi:10.1186/1750-1172-6-50
  • Dijk F, Gabriel S, van Dooren MF, et al. Clinical presentation of pontocerebellar hypoplasia due to mutations in the EXOSC3 gene. Eur J Hum Genet. 2012;20(7):725-729. doi:10.1038/ejhg.2012.1
  • Tsen54-Related Pontocerebellar Hypoplasia. In: OMIM [Internet]. Bethesda (MD): National Center for Biotechnology Information, National Library of Medicine; 1993-2022. Available from: https://www.ncbi.nlm.nih.gov/omim/618180
  • Brookman D. Pontocerebellar Hypoplasia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK526006/