Diprosopus

Diprosopus (from Greek διπρόσωπος, " Two Faces " ), also known as craniofacial duplication or double face, is an extremely rare inherited disorder in which a part or the whole face is duplicated on the head.

Formation

Although Diprosopus is classically viewed as Siamese twinning, this anomaly usually does not occur due to fusion or incomplete separation of two embryos, but is the result of the protein Sonic hedgehog. This protein and its corresponding gene play an important role in the formation of facial features during embryonic development. Among other things, governs the width of facial features. In excess it leads to widening of facial features and to duplication of facial structures. The larger the spacers are, the more structures are duplicated, often in mirror image form. In the laboratory this effect was demonstrated that chickens, where sonic hedgehog pellets were introduced into the embryo was born later dual beak. Inadequate amounts of this protein, however, lead to opposite results as cyclopia where facial structures are not adequately trained.

Even the healthy development of the brain depends on the signal function of the sonic hedgehog protein. During embryonic development, the protein directs embryonic stem cells in certain areas that form specialized neural tissue later, thus controlling the size and shape of brain structures.

Occurrence

Diprosopus often occurs in combination with other malformations, especially with anencephaly, a neural tube defect and cardiac malformations. When present, the brain may have abnormalities ranging from partial or complete duplication to the underdevelopment of brain tissue.

There are only a few animals survived with two faces over a longer period, due to the associated with the disorder abnormalities of the internal organs and the brain. One of the most famous was Ditto the pig. Ditto survived to adulthood, but then died of a disease caused by inhalation of feed pneumonia due to simultaneous seizure and breathing through the mouth two existing openings.

Cats

Cats with this malformation are after the Roman god Janus, who has two faces, called Janus cats.

In July 2006, attracted a six year old cat called "Frank and Louie " from Millbury attention. In his case, only one esophagus and trachea was functional, which simplified survival. When Frank and Louie in September 2011 was twelve years old, it was announced that he would appear in the Guinness Book of Records of 2012, so far as the longest- surviving Janus cat.

In June 2013 it was reported again on a Janus cat. The kitten " Doucy " was discovered in Oregon of children. As the mother cat did not accept their offspring, Doucy is drawn by hand. According to a veterinarian who examined the kitten, it is completely healed to this malformation and thus has good chances of survival.

People

Most human infants with this malformation are stillborn. Known cases of people who have thus survived longer than a few minutes to hours, are very rare, and only a few are recorded. In the years 2002 and 2003, two living male infants were described in separate case reports in the medical literature. One of the babies was born with a nose and doubled twice the frontal lobes, two widely spaced eyes, a small, underdeveloped eyes cave in the middle and a large, asymmetric mouth. The other infant had a double upper and lower jaw, two ending in the same root tongues, a cleft lip and cleft palate, a slightly divided tip of the nose, two widely spaced eyes, no brain beams, a doubled pituitary and abnormalities in the midbrain. Because they still had only a partial expression of malformations, both children were considered candidates for surgical correction of their abnormal facial features.

Lali Singh

In 2008 the girl Lali Singh was born in India, which is now regarded as the most famous person with full Diprosopus. She was born on 10 March 2008 in the village Sanai Sampūra in Delhi. The birth was delayed due to their large head of dystocia, and they came in a hospital by an episiotomy to the world. She was one of the few infants who survived well after birth and the only known living person with a full doubling of the face. It had two pairs of eyes, two noses and two mouths, but only one pair of ears. In her village, she was considered to be a reincarnation of Goddess Durga, who has three eyes, or as an incarnation of the Hindu god Ganesha.

In April 2008, the parents Sushma and Vinod Singh reported from a range of local doctors to scan her daughter by computer or magnetic resonance imaging. Without these images, it was not possible to detect the full range of the fault and the condition of the infant, the brain and other vital structures in the head and neck. Thus any assessment of their viability could only be speculative, although her ​​family described her as functioning normally. Similarly, it is also unknown whether neurosurgeons or craniofacial surgeons feasible solutions in terms of corrective surgery could offer. A local doctor told reporters that the baby should be seen as a healthy child, who led a normal life, which until then had been affected by this disorder was unique.

Lalis middle two eyes had a corneal opacity due to the abnormal anatomy of the facial muscles, which made it impossible for her to close the eyes completely. Initially, the camera flashes had been made responsible for incorrectly.

The cleft palate caused problems to feed the infant under the village conditions sufficient. A poor diet with sugar solution and diluted milk, which was dropped with the bottle directly into the throat because she could not swallow properly, weakened their condition and caused vomiting and infections. A hospitalization but was delayed by discussions between their extended family and the village chief. Finally, the parents brought it due to her illness and dehydration against the will of the other relatives to the hospital where her condition began with antibiotics and a drip to improve with saline under medical treatment. The vomiting stopped, they drank milk again and had normal bowel movements. But six hours later, when she was on the day exactly two months old, she died of a heart attack. She was buried in her village, as it is usual in Hinduism with children who die very young. Later, a Hindu temple was built in her village in her memory.