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Autosomal Dominant Spastic Ataxia Type 1

ADSA


Presentation

  • She is board certified in Neurology (1997-present) and is a member of the American Academy of Neurology, the American Neurological Association and the Movement Disorder Society.[books.google.com]
  • At first presentation, approximately 60% were found to have limb ataxia, 80% showed some pyramidal involvement and 50% had both pyramidal and cerebellar involvement.[acnr.co.uk]
  • Nystagmus is sometimes present.[disorders.eyes.arizona.edu]
  • Clinical description The disease typically presents in the 4th decade (age range 4-74 years).[orpha.net]
Italian
  • He is member of the Italian Society of Radiology (SIRM), European Society of Radiology (ESR), Radiological Society of North America (RSNA), American Roentgen Ray Society (ARRS) and European Society of Neuroradiology (ESNR) and serves as Reviewer of more[books.google.com]
  • Unlike FRDA, spinal scoliosis is not a prominent feature 18 but has been described in Tunisian 14 and Italian 21 series.[acnr.co.uk]
  • It represents the only CNR Institute authorized by the Italian National Health Service.[cnr.it]
  • Preliminary evidence of focal muscle vibration effects on spasticity due to cerebral palsy in a small sample of Italian children.[en.wikipedia.org]
  • Magariello A, et al: Mutation analysis of the SPG4 gene in Italian patients with pure and complicated forms of spastic paraplegia. J Neurol Sci 2010;288:96-100.[karger.com]
Constipation
  • […] found but may be more prominent amongst cases involving SACS gene deletions. 9, 21, 24 Bladder and bowel symptoms are not well-studied in ARSACS although urinary urge incontinence has been most commonly described. 2,6,18,21,23 Faecal incontinence and constipation[acnr.co.uk]
Diarrhea
  • SYN: fulminating d.. viral d. profuse watery diarrhea thought to be caused by infection with a virus. dyserethism (dis-er′e-thizm) A condition of slow response to stimuli.[theodora.com]
Mitral Valve Prolapse
  • Although mitral valve prolapse was described in the original cases of ARSACS, 2 this finding has not been replicated in subsequent studies of families outside Québec.[acnr.co.uk]
Abnormal Eye Movement
  • The second part of the book applies this synthesis to the clinical and laboratory evaluation of patients with abnormal eye movements due to a broad range of disorders - from muscular dystrophy, and genetic disorders, to dementia, including visual and[books.google.com]
  • Clinical signs are varied, with some patients having limb and gait ataxia along with episodic headaches or nausea, and others having gait ataxia, speech difficulty, and abnormal eye movements.[encyclopedia.com]
  • Spastic Ataxia 8, Autosomal Recessive, with Hypomyelinating Leukodystrophy Clinical Characteristics Ocular Features: Reported ocular signs are limited to abnormal eye movements.[disorders.eyes.arizona.edu]
Onset in Adolescence
  • Ataxia telangiectasia has many features in common with AOA together with cutaneous and scleral telangiectasiae, diabetes, immunodeficiency and sensitivity to radiation causing tumours. 19 Late-onset Alexander’s disease may have onset in adolescence and[acnr.co.uk]
  • SCA11 progresses slowly over decades, with onset between adolescence and young adulthood. All individuals develop gait disorders, increased reflex action, eye disturbances and irregular movements, and speech difficulties.[encyclopedia.com]
Incontinence
  • […] has been most commonly described. 2,6,18,21,23 Faecal incontinence and constipation may also be a problem in patients with long disease duration. 18 Co-existent epilepsy has been described in a minority of cases and it remains unclear whether this is[acnr.co.uk]
  • Urge incontinence of bladder and rectum is sometimes a feature. Genetics Bialllelic mutations in the CYP7B1 gene (8q12.3) have been identified in this disorder resulting in a marked accumulation of neurotoxic oxysterols in plasma and CSF.[disorders.eyes.arizona.edu]
Hyperreflexia
  • Affiliated tissues include eye, and related phenotypes are supranuclear gaze palsy and hyperreflexia UniProtKB/Swiss-Prot : 75 Spastic ataxia 1, autosomal dominant: An autosomal dominant form of spastic ataxia, a progressive neurodegenerative disorder[malacards.org]
  • Hyperreflexia and a positive Babinski sign are commonly presently. Mild cognitive impairment and depression have been seen in a minority of patients. Brain MRIs show cerebellar hemispheric and vermian atrophy.[disorders.eyes.arizona.edu]
  • -- 18p11.22-q11.2 Spinocerebellar ataxia (SCA29) OMIM #117360 Early onset, nonprogressive ataxia Vermian hypoplasia -- 18p11.22-q11.2 Spinocerebellar ataxia(SCA30) OMIM #613371 Dysarthria Lower limb hyperreflexia Hypermetric saccades -- 4q34.3-q35.1[emedicine.medscape.com]
  • SCA3 type 1 (MJD Type 1, see this term) is associated with ataxia, ophthalmoparesis, pyramidal signs such as spasticity and hyperreflexia, and extrapyramidal signs including dystonia and other movement disorders presenting in adolescence.[orpha.net]
  • , mild SCA12 (autosomal dominant type 12) 5q31-q33, 66 CAG repeats in the promotor region, coding for protein phosphatase 2A Tremor, bradykinesia, parkinsonism, dementia, hyperreflexia SCA13 (single French family) 19q13.3-q13.4 (6q27 with CAG repeats[bcm.edu]
Abnormal Gait
  • Ataxia is a neurological feature of abnormal gait due to the lack of appropriate muscle coordination and it is a common clinical symptom in hundreds of different diseases.[centogene.com]
  • Other main symptoms are irregularities in the retina of the eye, bone and skin changes, and the abnormal gait, speech patterns, and muscle movements associated with cerebellar ataxia.[encyclopedia.com]
  • Furthermore, among the core symptoms of HSP are also included abnormal gait and difficulty in walking, decreased vibratory sense at the ankles, and paresthesia. [10] Individuals with HSP can experience extreme fatigue associated with central nervous system[en.wikipedia.org]
Spastic Gait
  • Dysarthria, dysphagia, and a spastic gait are experienced by the majority of individuals. Hyperreflexia and a positive Babinski sign are commonly presently. Mild cognitive impairment and depression have been seen in a minority of patients.[disorders.eyes.arizona.edu]
  • If symptoms begin during the teenage years or later, then spastic gait disturbance usually progresses over many years.[en.wikipedia.org]
Abnormal Reflex
  • The patient showed the classic triad of early childhood-onset cerebellar ataxia, peripheral neuropathy and pyramidal tract signs such as spasticity, abnormal reflexes and the loss of the ability to perform fine motor movements.[e-jmd.org]

Workup

  • In adults, Vitamin E and occasionally Vitamin B-12 deficiency are rarely a cause of chronic progressive ataxia and should not be overlooked in a diagnostic workup.[movementdisorders.org]
Dyslipidemia
  • Kompoliti’s include the gender differences in Parkinson’s disease and other movement disorders, studies to define the effect of neuroleptics on weight, risk for diabetes and dyslipidemia in patients with Tourette syndrome, and define the current status[books.google.com]

Treatment

  • This network is dedicated to the acceleration of clinical trials in search of effective treatments for SMA.[books.google.com]
  • Treatment Treatment Options: No treatment has been reported.[disorders.eyes.arizona.edu]
  • Management and treatment In the absence of specific treatments to slow or stop disease progression, care is supportive. For example, parkinsonism, restless legs syndrome, spasticity, sleep disorders and depression can be treated pharmacologically.[orpha.net]
  • Treatment team Neurologists and geneticists are the front line treatment team for people with ataxia, along with specialized nurses and therapists.[encyclopedia.com]

Prognosis

  • Prognosis Prognosis is poor. In the late stages of the disease, usually 10 to 15 years following onset, bulbar dysfunction secondary to affection of lower medullary nuclei results in aspiration which is life-threatening.[orpha.net]
  • The prognosis is bleak, with a gradual progression to disability and death within 10-20 years. Ref: Orr, H.T. et al. (1993). Expansion of an unstable CAG trinucleotide repeat in spinocerebellar ataxia type I. Nature Genet. 4, 221-26.[gpnotebook.co.uk]
  • Prognosis The prognosis for a person with ataxia depends upon the type and nature of the disease. Ataxia as a result of trauma or infection may be a temporary condition, or leave some degree of permanent disability.[encyclopedia.com]
  • Prognosis [ edit ] Although HSP is a progressive condition, the prognosis for individuals with HSP varies greatly. It primarily affects the legs although there can be some upperbody involvement in some individuals.[en.wikipedia.org]

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 SCA1 is caused by CAG repeat expansions in the ATXN1 gene region on chromosome 6p23. Prognosis Prognosis is poor.[orpha.net]
  • Abstract We describe 4 siblings with spastic paraparesis and peroneal amyotrophy who were prone to severe pain and painful dysesthesias, tetraparesis and pyramidal signs during pyrexial episodes of variable etiology.[link.springer.com]
  • Article / Publication Details First-Page Preview Abstract Objective: Investigation of etiological factors in mental retardation (MR).[karger.com]

Epidemiology

  • Consequently, they are often approached together in epidemiological studies.[karger.com]
  • Summary Epidemiology Prevalence is estimated to be 1-2 in 100,000 with significant geographical and ethnic variations. Clinical description The disease typically presents in the 4th decade (age range 4-74 years).[orpha.net]
  • Case control studies and epidemiological studies, including genetic sequencing of ARCA, are needed in Korea.[e-jmd.org]
Sex distribution
Age distribution

Pathophysiology

  • In this review, we summarise the clinical, genetic and pathophysiological features of this condition, and the investigations used in its diagnosis.[acnr.co.uk]
  • Clinical, genetic, molecular, and pathophysiological insights into spinocerebellar ataxia type 1. Cerebellum. 2008;7(2):106-14. doi: 10.1007/s12311-008-0009-0. Review. Zoghbi HY, Orr HT.[ghr.nlm.nih.gov]
  • . • Researchers are rapidly learning about the underlying pathophysiology behind the inherited ataxia syndromes.[medlink.com]
  • Interestingly, the consistent pattern of selective temporal RNFLT reduction in our study prompts the question of pathophysiologic relevance.[journals.plos.org]
  • Matilla‐Dueñas A, Goold R and Giunti P (2008) Clinical, genetic, molecular, and pathophysiological insights into spinocerebellar ataxia type 1. Cerebellum 7(2): 106–114.[els.net]

Prevention

  • Prevention of secondary complications: Joint contractures can be prevented by appropriate physiotherapy. Surveillance: annual neurologic examination.[lacaf.org]
  • These aggregates prevent the ataxin-1 protein from functioning normally, which damages cells and leads to cell death. For reasons that are unclear, aggregates of ataxin-1 are found only in the brain and spinal cord (central nervous system).[ghr.nlm.nih.gov]
  • Treatment [ edit ] No specific treatment is known that would prevent, slow, or reverse HSP. Available therapies mainly consist of symptomatic medical management and promoting physical and emotional well-being.[en.wikipedia.org]
  • Conclusion: Establishing the diagnosis in older mentally retarded patients is important in the prevention of medical complications and in the development of management strategies for the institution.[karger.com]
  • Treatment Except for some acquired and reversible forms of ataxia as initially described, there is no cure or preventive treatment for the progressive forms of the disease, or for those ataxias resulting from accidental lesions of motor brain areas and[encyclopedia.com]

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