Is gross motor delay secondary to bilateral vestibular hypofunction in Jervell and Lange-Nielsen syndrome?

Abstract

Jervell and Lange-Nielsen syndrome is a rare autosomal recessive condition characterized by bilateral profound sensorineural hearing loss, and prolonged QT interval that may result in ventricular tachycardia leading to syncope, cardiac arrest or sudden death. Treatment of the arrhythmias is often life-saving as this condition has a high mortality if untreated. We describe 3 cases of Jervell and Lange-Nielsen syndrome, who presented with profound sensorineural hearing loss and delayed gross motor milestones and have evidence of bilateral vestibular hypofunction on vestibular testing. We suggest that vestibular hypofunction is associated with this syndrome and evaluation of vestibular function may increase the diagnostic yield in the asymptomatic stage of this rare, but severe form of long QT syndrome. Clinicians should consider Jervell Lange-Nielsen in the differential diagnosis of ‘non-syndromic’ profound sensorineural hearing loss presenting with vestibular failure, along with Usher syndrome type 1, and morphological malformations of the vestibular apparatus. However, more studies are needed to confirm these findings.

Key words::

• Jervell and Lange-Nielsen syndrome
• congenital profound sensorineural hearing loss
• prolonged QTc
• delayed motor milestones
• vestibular function

Acknowledgements

We would like to thank the families for their cooperation. M.B-G is supported by Great Ormond Street Children's Charity.

Declaration of interest: None declared.