Presentation
Chorea is present at onset in 80% of patients and upper limb dystonia (see this term) occurs in about 50% of individuals. [orpha.net]
They commonly present during adulthood, but less commonly can present during childhood. The family history of autosomal dominant ataxia is the key determining factor. [lecturio.com]
Telangiectasias develop from about the age of 3 years and may not be present until the age of 10 years, but will be present in all cases. [patient.info]
These patients present with gait ataxia usually with headache and papilledema. Progressive hydrocephalus can also present with subacute-onset ataxia. [jpgmonline.com]
Acronym AOA Synonyms AOA1 Ataxia early-onset with oculomotor apraxia and hypoalbuminemia Ataxia-oculomotor apraxia 1 Cerebellar ataxia early-onset with hypoalbuminemia EAOH EOCA-HA Keywords Disclaimer Any medical or genetic information present in this [uniprot.org]
Entire Body System
- Movement Disorder
Problems with the cerebellum include Cancer Genetic disorders Ataxias - failure of muscle control in the arms and legs that result in movement disorders Degeneration - disorders caused by brain cells decreasing in size or wasting away Treatment of cerebellar [medlineplus.gov]
Progressive ataxia associated with ocular apraxia type 1 (AOA1) with a presence of a novel mutation on the aprataxin gene 1 Parkinson's Clinic of Eastern Toronto and Movement Disorders Center, Toronto, Canada 2 Department of Life Sciences, University [annalsofian.org]
Antidyskinetic drugs The literature on the treatment of movement disorders in AT is scarce. [raredisorders.imedpub.com]
Category Nervous system disease Brite Human diseases [BR:br08402] Nervous system diseases Neurodegenerative diseases H00848 Ataxia with ocular apraxia Human diseases in ICD-11 classification [BR:br08403] 08 Diseases of the nervous system Movement disorders [genome.jp]
Fortunately, the movement disorders tend to settle with age. Slurred Speech (Dysarthria) This is very common and may progress with time. Most patients, however, can make themselves understood. [atsociety.org.uk]
- Falling
[…] sensory loss (predominantly in lower limbs) Muscle Soft Tissue: distal muscle atrophy, predominantly lower limbs distal muscle weakness, predominantly lower limbs Neurologic Central Nervous System: ataxia dysarthria dysmetria cerebellar atrophy frequent falls [malacards.org]
There is a broad based stance, inability to maintain the head in the proper position so that it oscillates, there is hypermetria or hypometria, direction cannot be maintained and the animal falls easily, often in an exaggerated way. congenital ataxia [medical-dictionary.thefreedictionary.com]
The index patient, a 33-year-old male, complained of frequent falls and unsteady legs from the age of 14-years. Subsequently, he suffered from arms dysmetria, truncal ataxia and cerebellar dysarthric speech. [cags.org.ae]
Balance gradually declines and it may be noticed that running is easier than walking i.e. the child falls less. By 16-17 years after onset of the condition a wheelchair may be required. [atsociety.org.uk]
Many symptoms of Ataxia can mimic those of being drunk – slurred speech, stumbling, falling, and incoordination. All are related to degeneration of the part of the brain, called the cerebellum, that is responsible for coordinating movement. [ataxia.org]
- Epilepsy
[…] disability syndrome Autosomal recessive cerebellar ataxia-epilepsy-intellectual disability syndrome due to RUBCN deficiency Autosomal recessive cerebellar ataxia-epilepsy-intellectual disability syndrome due to TUD deficiency Autosomal recessive cerebellar [se-atlas.de]
[…] mitochondrial disease, multisystem disorders, immune defects, Miller-Fisher syndrome), multiple sclerosis, paraneoplastic, infections (CNS, acute ataxia, viral, Creutzfeldt-Jakob disease, meningitis mass lesion), abscess, neoplasm, sarcoid, paroxysmal, epilepsy [medical-dictionary.thefreedictionary.com]
Scalais E, Chafai R, Van Coster R, Bindl L, Nuttin C, et al: Early myoclonic epilepsy, hypertrophic cardiomyopathy and subsequently a nephrotic syndrome in a patient with CoQ 10 deficiency caused by mutations in para-hydroxybenzoate-polyprenyl transferase [karger.com]
[Dose-dependent relationship of chronic use of phenytoin and cerebellar atrophy in patients with epilepsy]. Arq Neuropsiquiatr 2000;58:276-81. 11. Schöls L, Linnemann C, Globas C. [jpgmonline.com]
Rundataxin-related ataxia: A new form of pure recessive cerebellar ataxia accompanied by epilepsy and mental retardation named ‘Salih ataxia’ has been described in a large consanguineous Saudi Arabian family with three affected individuals[ 107 ]. [wjgnet.com]
- Developmental Disorder
Clinical description Based on clinicogenetic criteria, five main types ARCA can be distinguished: congenital ataxias (developmental disorders), ataxias associated with metabolic disorders, ataxias with a DNA repair defect, degenerative ataxias, and ataxia [orpha.net]
Cardiovascular
- Hypotension
The clinical picture is often aggravated by muscular hypotension that combined with the described ataxia leads to motor development delay. COMA is rarely associated with NPH and is only described in mutations of NPHP1, 4, 6 and 8. [neocyst.de]
Extracerebellar signs and related diseases: 3,4 Orthostatic hypotension, dysphonia, dystonia, pyramidal signs, and parkinsonism: MSA-C (the most common non-genetic degenerative ataxia). [practicalneurology.com]
The most frequent cause of complete Bálint's syndrome is said by some to be sudden and severe hypotension, resulting in bilateral borderzone infarction in the occipito-parietal region. [1] More rarely, cases of progressive Bálint's syndrome have been [en.wikipedia.org]
He reported autonomic dysfunction such as orthostatic hypotension, urinary incontinence, and impotence. He was able to ambulate but needed help in his daily activities. [frontiersin.org]
Neurologic
- Ataxia
ataxia and ataxia–telangiectasia (A–T) ( Di Donato et al ., 2001 ). [academic.oup.com]
The features include early childhood onset of ataxia and oculomotor apraxia, mimicking ataxia telangiectasia but without the extraneurologic findings of ataxia telangiectasia. [ncbi.nlm.nih.gov]
These hereditary ataxias include Freidreich ataxia (FDRA), spinocerebellar ataxia, and ataxia with oculomotor apraxias types 1 (AOA1) and 2 (AOA2). [1] FDRA is a recessive ataxia characterized by a mutation on chromosome 9q13. [2] It consists of a repeated [annalsofian.org]
- Apraxia
Abstract Ataxia-oculomotor apraxia is a distinct entity first comprehensively described in 1988. [ncbi.nlm.nih.gov]
Pathways for Ataxia-Oculomotor Apraxia 3 GO Terms for Ataxia-Oculomotor Apraxia 3 Sources for Ataxia-Oculomotor Apraxia 3 [malacards.org]
AOA includes ataxia telangiectasia (AT), ataxia telangiectasia like disorder (ATLD), ataxia oculomotor apraxia type 1 (AOA1) and ataxia oculomotor apraxia type 2 (AOA2). [genome.jp]
- Peripheral Neuropathy
Three patients with AOA1 were identified in an APTX mutation screening on 28 Southern Italian patients with progressive ataxia and peripheral neuropathy. [neurology.org]
Later, peripheral axonal motor neuropathy dominates the clinical picture. [orpha.net]
Format Definition An autosomal recessive syndrome characterized by early-onset cerebellar ataxia, oculomotor apraxia, early areflexia and late peripheral neuropathy. [uniprot.org]
No patient was lacking both peripheral neuropathy and cerebellar atrophy. [lib.ugent.be]
Management Supportive—e.g., physical therapy for disabilities due to peripheral neuropathy, assistive devices as needed, educational support. [medical-dictionary.thefreedictionary.com]
- Dysarthria
Affiliated tissues include eye, and related phenotypes are nystagmus and dysarthria UniProtKB/Swiss-Prot : 76 Ataxia-oculomotor apraxia 3: An autosomal recessive disease characterized by cerebellar ataxia, oculomotor apraxia, areflexia and peripheral [malacards.org]
Clinical description Cerebellar ataxia is the first manifestation of AOA1 with a mean age of onset of 4.3 years (2-10 years) and is characterized by progressive gait imbalance followed by dysarthria, and limb dysmetria. [orpha.net]
The clinical features included onset between 2 and 7 years of age, ataxia, ocular motor apraxia, choreoathetosis, depressed or absent deep tendon reflexes, dysarthria, masklike facies, intention tremor, and mildly subnormal intellectual function in one [pediatricneurologybriefs.com]
Other variable signs include dysarthria, choreiform or athetoid movements, facial grimacing, tongue and limb fasciculations, areflexia, and distal sensory deficits. All symptoms are progressive and ambulation is lost within a decade of onset. [disorders.eyes.arizona.edu]
- Areflexia
Affiliated tissues include eye, and related phenotypes are nystagmus and dysarthria UniProtKB/Swiss-Prot : 76 Ataxia-oculomotor apraxia 3: An autosomal recessive disease characterized by cerebellar ataxia, oculomotor apraxia, areflexia and peripheral [malacards.org]
Format Definition An autosomal recessive syndrome characterized by early-onset cerebellar ataxia, oculomotor apraxia, early areflexia and late peripheral neuropathy. [uniprot.org]
The disease is characterized by ataxia, dysmetria, peripheral neuropathy, areflexia, cerebellar atrophy, oculomotor apraxia and raised alpha-fetoprotein levels. [cags.org.ae]
Ataxia, areflexia, and ocular muscle paralyses are also featured in the Fisher syndrome. [pediatricneurologybriefs.com]
AOA1 is primarily caused by mutations in APTX, while AOA2 is caused by mutations in the SETX gene. 1 The major clinical features of AOA1 include the following: Cerebellar ataxia, oculomotor apraxia, and areflexia Childhood onset Slow progression leading [centogene.com]
Workup
Figure 3 shows the workup leading to AOA1, AOA2 and AT diagnosis in view of the results of our study and previous reports18. Figure 3 Workup leading to AOA1, AOA2 and AT diagnosis in view of the results of our study and previous reports. [nature.com]
Treatment
Management and treatment No specific treatment exists for AOA1 and management is mainly supportive. [orpha.net]
Coverage includes major updates on genetics of diseases, new diagnostic techniques, and the newest treatment options. [books.google.de]
Attendance at a regular school is most often possible. treatment No causal treatment available. Symptomatic therapy of ataxia with physiotherapy and treatment of chronic renal failure. sources Betz R, Rensing C, Otto E, et al. [neocyst.de]
In some cases, there is no cure but treatment may help with symptoms. NIH: National Institute of Neurological Disorders and Stroke [medlineplus.gov]
Prognosis
Correct clinical and genetic diagnosis is important for appropriate genetic counseling and prognosis and, in some instances, pharmacological treatment. [orpha.net]
Exact pathomechanism not clear. progress and prognosis Jerky movements of the head as well as muscular hypotonia and ataxic gait improve with age. Attendance at a regular school is most often possible. treatment No causal treatment available. [neocyst.de]
There are few reports of the long-term prognosis of children born with OMA. The head thrusts associated with OMA typically diminish over time, but tend not to completely disappear. [aapos.org]
Prognosis The saccadic problem usually but not always improves with age. [neuroophthalmology.ca]
Etiology
She divided those with a known etiology (eg, abetalipoproteinemia, ataxia telangiectasia) from those whose etiology was unknown (eg, Friedreich ataxia, Ramsay Hunt syndrome, cerebellar ataxia with retinal degeneration). [medlink.com]
Etiology These diseases are caused by mutations in specific genes, some of which have been identified, such as frataxin in Friedreich ataxia, alpha-tocopherol transfer protein in ataxia with vitamin E deficiency (AVED), aprataxin in ataxia with oculomotor [orpha.net]
Regardless of etiologies, the area in brain which is usually affected remains to be superior parietal lobule (SPL) which is located in the parieto-occipital junction [2]. [ijsronline.net]
The etiology of OMA is usually not determined and considered idiopathic. However, the condition is sometimes considered secondary and attributed to insults occurring either during the perinatal period or the first 6 months of life. [bredagenetics.com]
Epidemiology
Summary Epidemiology This group encompasses a large number of rare diseases, the most frequent in the Caucasian population being Friedreich ataxia (estimated prevalence 2-4/100,000), ataxia-telangiectasia (1-2.5/100,000) and early onset cerebellar ataxia [orpha.net]
[…] phenotypic heterogeneity, both in clinical presentation (particularly in susceptibility to pulmonary infection, presence and degree of cognitive impairment and predisposition to leukaemia) and rate of progression, reflecting allelic diversity. [ 6 ] Epidemiology [patient.info]
An epidemiological study was conducted on 72 Italian AT families from the Italian Registry for Ataxia Telangiectasia applying the Dahlberg’s formula. [raredisorders.imedpub.com]
Epidemiological, clinical, paraclinical and molecular study of a cohort of 102 patients affected with autosomal recessive progressive cerebellar ataxia from Alsace, Eastern France: implications for clinical management. Neurogenetics 11, 1–12 (2010). [nature.com]
Pathophysiology
• Researchers are rapidly learning about the underlying pathophysiology behind the inherited ataxia syndromes. [medlink.com]
Etiology Ataxia telangiectasia is caused by biallelic mutations in the ATM gene Pathophysiology The ATM gene is a controller of the cell cycle and of the cellular response to oxidative stress and to DNA double strand breaks, the most toxic lesions of [clinicaladvisor.com]
Knowing the pathophysiology and the various interacting mechanism that lead to an invariable end-point of such impairment following these common neurological maladies can provide us with a window of much more refined management strategies. [ijsronline.net]
Pathophysiology The origin of congenital ocular motor apraxia is unclear. [neuroophthalmology.ca]
The pathophysiology of cerebellar ataxias is as diverse as the various neurological and systemic diseases affecting the cerebellum. [practicalneurology.com]
Prevention
A-T is a multisystem disorder requiring multiple therapeutic interventions to slow or halt the neurodegeneration, to prevent or treat the tumours and to correct the associated immunodeficiency. [patient.info]
Prevention of secondary complications: high-protein diet to prevent edema by restoring serum albumin concentration; low-cholesterol diet. Surveillance: routine follow-up with a neurologist. [lacaf.org]
Health care services aimed at preventing health problems or maintaining health are provided. 9. Patient-focused care is provided by working with health care professionals, including those from other disciplines. Medical Knowledge 10. [pediatriceducation.org]
The APTX gene encodes for the single strand break DNA repair protein. [4], [5] AOA1 is caused by a mutation on this gene. [6] The lack of functional APTX prevents the repair of breaks in DNA and has been shown to affect mitochondrial DNA to a great extent [annalsofian.org]
This shortage prevents the efficient repair of DNA damage, which leads to the accumulation of broken DNA strands. [ghr.nlm.nih.gov]