Autism in Moebius Syndrome: Comorbidity or a Coincidental State?

Pervasive developmental disorders are neuropsychiatric disorders that start in early years of life, last lifelong, and characterized by delay and abnormality in social relationship, communication, behavior and cognitive development. Moebius syndrome is a clinical condition characterized by unilateral or bilateral eye-face palsy associated with muscle or bone malformations in the upper or lower limbs. Most accepted clinical criteria to characterize the sequence are the involvement of the VI and VII cranial nerves. Though some authors suggest a causal relationship between autism and some medical conditions, to draw such result is quite complicated and difficult. Case reports and articles draw attention to the comorbidity of autism in Moebius syndrome. Despite arguments favoring a strong relationship between autism and Moebius syndrome, some questions about this relationship are still left unanswered and controversial. There are some research findings suggesting higher prevalence of autism among patients with Moebius syndrome, however some others did not report an increase in autism prevalence in Moebius syndrome. Clinical features of Moebius syndrome comprise difficulties in making diagnosis of autism. Long term follow-up of larger number of cases are necessary to understand whether the presence of both autism and Moebius syndrome in a patient represents comorbidity or only a coincidental condition.