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Neuroferritinopathy

Neurodegeneration with Brain Iron Accumulation 3


Presentation

  • The relevant articles were reviewed with a focus on the pathophysiology, clinical presentation, differential diagnoses, and management of NF.[academiccommons.columbia.edu]
  • We present video case reports of 4 individuals with neuroferritinopathy chosen to illustrate how this disorder can present and subsequently progress clinically.[ncbi.nlm.nih.gov]
  • Methods : case work up Results : Family 1: A 31 year old female presented with complaints of abnormal movements for last 5 years, starting in her right leg and progressing rapidly to other limbs.[mdsabstracts.org]
  • An update on advances in neuroimaging and pathology of metal related disease is also presented.[books.google.com]
  • Global cognitive decline cognitive deficits in all modalities present.[academic.oup.com]
Hypomimia
  • While 35% developed facial hypomimia and bradykinesia not directly related to their dystonia; only one individual developed a pure rest tremor, and another had tremor present at rest and on intention.[academic.oup.com]
Hyperreflexia
  • […] basal ganglia 0007007 Choreoathetosis 0001266 Decreased serum ferritin Low ferritin level Reduced serum ferritin [ more ] 0012343 Disinhibition 0000734 Dysarthria Difficulty articulating speech 0001260 Emotional lability Emotional instability 0000712 Hyperreflexia[rarediseases.info.nih.gov]
  • Children with PKAN typically manifest gait problems around age 3 and later develop progressive dystonia, dysarthria, rigidity, spasticity, hyperreflexia and extensor toe signs.[nbiaalliance.org]
Cerebellar Sign
  • With the exception of the reported cerebellar signs, the clinical presentation of the patients with the 498InsTC and 646InsC mutations fall within the spectrum we have seen in patients with 460InsA.[academic.oup.com]
Babinski Sign
  • sign 0003487 Blepharospasm Eyelid spasm Eyelid twitching Involuntary closure of eyelid Spontaneous closure of eyelid [ more ] 0000643 Cavitation of the basal ganglia 0007007 Choreoathetosis 0001266 Decreased serum ferritin Low ferritin level Reduced[rarediseases.info.nih.gov]
  • signs ( Vidal et al ., 2004 ).[academic.oup.com]

Workup

  • (See Presentation and Workup.) [4, 5 , 6] PKAN is relentlessly progressive. The clinical course is characterized by progressive dementia, spasticity, rigidity, dystonia , and choreoathetosis.[emedicine.medscape.com]

Treatment

  • The disorder provides a direct link between disordered iron storage and a neurodegenerative disease, opening new avenues for treatment by altering brain iron stores in addition to symptomatic treatments such as local Botulinum toxin and oral anti oxidants[ncbi.nlm.nih.gov]
  • Treatment: Treatment of manifestations: Standard doses of levodopa, tetrabenazine, orphenadrine, benzhexol, sulpiride, diazepam, clonazepam, and Deanol for the movement disorder; botulinum toxin for painful focal dystonia.[medigoo.com]
  • All three harbouring the pathogenic c.460InsA mutation showed iron deposition; these findings show pathological iron accumulation begins in early childhood which is of major importance in understanding and developing treatment for NBIA.[ncbi.nlm.nih.gov]
  • Since its discovery in 2001, there have been significant developments in our understanding of the pathological, radiological, and clinical aspects of the condition, though several key pathomechanistic questions, and crucially treatment paradigms, remain[ncbi.nlm.nih.gov]
  • […] and prognosis No disease-specific treatment is available and symptomatic management is recommended 2 . 1.[radiopaedia.org]

Prognosis

  • […] caudate, substantia nigra, and cerebellar nuclei, these are reflective of cystic changes 3 T1 : hypointense ring surrounding aforementioned cystic changes 3 GRE/SWI : markedly hypointense ring surrounding aforementioned cystic changes 3 Treatment and prognosis[radiopaedia.org]
  • This score correlates with patient prognosis, and the ability to... In patients with PC accurate preoperative assessment is essential to determine a «road map» for choosing an optimal type of treatment and to ensure optimal outcome.[posterng.netkey.at]
  • (See Presentation and Prognosis.) [7, 8 ] The disease can be familial or sporadic.[emedicine.medscape.com]
  • Management and prognosis Monitoring Asymptomatic patients with proven homozygosity for C282Y Yearly exam of skin, heart, liver, joins, and (in men) testes iron %sat Patients with hereditary hemochromatosis hepatic cirrhosis Q6mo serum AFP and liver ultrasound[faculty.washington.edu]

Etiology

  • Non-genetic etiologies are discussed, including medications, structural lesions, psychogenic causes, and metabolic abnormalities. This book describes in detail the latest clinical and etiological information regarding the causes of chorea.[books.google.com]
  • This chapter summarizes the genetic etiology, pathological, radiological, and clinical data from all published data to date and suggested potential new avenues for therapy.[ncbi.nlm.nih.gov]
  • This book describes in detail the latest clinical and etiological information regarding chorea. Management strategies, pathophysiology, and associated medical and psychiatric problems associated with chorea are also addressed.[books.google.com]
  • Treatment Due to neuroferritinopathy’s genetic etiology, the disorder is not currently curable. Furthermore, progression of the disorder is unable to be effectively halted. Therefore current treatment focuses on managing symptoms of the disorder.[dict.eudic.net]

Epidemiology

  • Epidemiology Map of England Neuroferritinopathy was first discovered in 2001, with its first case being reported in Cumbria from Northern England.[dict.eudic.net]
  • Symptoms affecting movement (dystonia) have also been treated with L-Dopa , orphenadrine , benzhexol , sulpiride , diazepam , clonazepam , and deanol . [4] Parkinsonian symptoms were not decreased by L-Dopa . [1] Iron supplements should be avoided. [4] Epidemiology[en.wikipedia.org]
  • […] affecting movement (dystonia) have also been treated with L-Dopa , orphenadrine , benzhexol , sulpiride , diazepam , clonazepam , and deanol . [ 4 ] Parkinsonian symptoms were not decreased by L-Dopa . [ 1 ] Iron supplements should be avoided. [ 4 ] Epidemiology[research.omicsgroup.org]
  • The 460InsA insertion was not present in the 100 anonymized samples from the Cumbrian population collected as part of a resource for genetic epidemiology.[academic.oup.com]
Sex distribution
Age distribution

Pathophysiology

  • The relevant articles were reviewed with a focus on the pathophysiology, clinical presentation, differential diagnoses, and management of NF.[academiccommons.columbia.edu]
  • Management strategies, pathophysiology, and associated medical and psychiatric problems associated with chorea are also addressed.[books.google.com]
  • Psychopathology, management, and pathophysiology of chorea, are also addressed.[books.google.com]
  • Neuroferritinopathy: Pathophysiology, Presentation, Differential Diagnoses and Management. Tremor and other hyperkinetic movements (New York, N.Y.). 6: 355. doi:10.7916/D8KK9BHF - Pubmed 3. Fatima Z, Ishigame K, Araki T.[radiopaedia.org]

Prevention

  • Prevention of secondary complications: Adequate caloric intake; physiotherapy to maintain mobility and prevent contractures. Agents/circumstances to avoid: Iron supplements are not recommended. NOTE: The above information is for processing purpose.[medigoo.com]
  • Department Medical specialty News Contact User login Username or e-mail * Password * Request new password Your name * Your e-mail address * Subject * Category * Message * CAPTCHA This question is for testing whether or not you are a human visitor and to prevent[karyo.gr]
  • Prevention of Secondary Complications Dietary assessment is helpful; affected individuals should maintain caloric intake. Physiotherapy helps to maintain mobility and prevent contractures.[ncbi.nlm.nih.gov]
  • Long-term surveillance for neuroferritinopathy can include: Regular assessment of nutrition and caloric intake Physiotherapy to maintain mobility and prevent contractures (permanent tightening of a muscle or joint).[nbiacure.org]
  • Ferritin stores essential iron inside cells and prevents the iron causing damage. The error leads to large amounts of iron and ferritin collecting in the cells and causing problems with body movements.[news.bbc.co.uk]

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