Presentation
Median age at presentation to the reporting paediatrician: 7 years 9 months. [adc.bmj.com]
Furthermore, these two cases had CLN5 mutation which usually presents as vLINCL and presented with typical phenotype of CLN5. Case 3 had a different granular inclusion body. [pediatricneurosciences.com]
Two 7-year-old girls presented with decreased visual acuity, clumsiness, night blindness, and behavioral problems. [journals.lww.com]
The outcome from this engagement will be presented to committee for decision-making and therefore this topic will have a 3rd meeting on 25 July 2018. [nice.org.uk]
Furthermore, sera from patients with Type 1 diabetes, a disease with present anti-GAD65 antibodies, stained differently from JNCL sera. [eyewiki.aao.org]
Entire Body System
- Difficulty Walking
People with this form of CLN8 disease have increasing difficulty walking and coordinating movements (ataxia), eventually becoming immobile. [icdlist.com]
Eyes
- Retinal Lesion
lesions and rapidly progressive dementia. [icd10data.com]
Musculoskeletal
- Leg Weakness
Eventually, usually during the late teens or twenties, additional abnormalities develop including sudden involuntary muscle contractions (myoclonus), muscle spasms (spasticity) that result in slow, stiff movements of the legs, weakness or paralysis of [rarediseases.org]
Neurologic
- Myoclonus
Rothdach-AJ; Dietl-T; Kumpfel-T; Gottschalk-M; Schumann-EM; Trenkwalder-C Familiar myoclonus-renal failure syndrome NERVENARZT-. [malattierare.regione.veneto.it]
Other features like myoclonus, ataxia and vision loss develop later in the course with optic atrophy being detectable within 2½ years of vision loss. [annalsofian.org]
Clinical manifestations include seizures, progressive mental and motor deterioration, myoclonus, visual failure, dementia and premature death. [alliedacademies.org]
As with younger affected children, older individuals develop a decline in intellectual function, myoclonus, epilepsy, and vision loss. [icdlist.com]
Involuntary movements (ataxia, myoclonus or spastic quadriparesis) occur. Myoclonus may be severe and refractory to medications. Visual loss occurs but is less obvious for the same reason as in CLN1. ERG is effective to evaluate visual acuity. [omicsonline.org]
- Mental Deterioration
[…] partial seizures, and mental and motor deterioration. [brainfoundation.org.au]
Signs and symptoms include progressive vision loss, progressive motor skills deterioration, mental impairment, and seizures. Infantile neuronal ceroid lipofuscinosis in which the signs and symptoms appear later in life. [icd10data.com]
deterioration and fits and is invariably fatal, usually in the early 20s. [eyewiki.aao.org]
Here the authors report a case of a 9-year-old boy who presented with progressive mental and social deterioration since the age of 2½ years. [annalsofian.org]
Hirvasniemi A, Lang H, Lehesjoki AE, Leisti J (1994) Northern epilepsy syndrome: An inherited childhood onset epilepsy with associated mental deterioration. J Med Genet 31: 177-182. [omicsonline.org]
- Dystonia
Treatment Treatment Options: Treatment is primarily symptomatic for sleep disorders, seizures, psychoses, malnutrition, dystonia and spasticity. [disorders.eyes.arizona.edu]
Neurologic examination showed disorientation for time and space, impairment of short- and long-term memory, dysarthria, oromandibular dystonia, and naming deficit. A pendular nystagmus was present. [catalog.coriell.org]
Louis (296) Pharmacogenetics (280) Los Angeles (264) Houston (244) Hybrids (242) San Antonio (221) Arkansas (201) Dystonia (185) Chicago (180) UCLA Research Institute (175) Repository Linkage Families (164) CMD Specific (154) Venezuelan Huntington Disease [coriell.org]
- Profound Intellectual Disability
intellectual disabilities 2016 2017 2018 2019 Billable/Specific Code Applicable To IQ level below 20-25 Profound mental subnormality amaurotic E75.4 (Bielschowsky(-Jansky)) (family) (infantile (late)) (juvenile (late)) (Vogt-Spielmeyer) Jansky-Bielschowsky [icd10data.com]
Workup
A diagnostic workup is initiated based on patient presentation, however, aside from tests of gene sequencing, and electron and light microscopy, several other ophthalmic imaging modalities can be useful in confirming the diagnosis with characteristic [eyewiki.aao.org]
Treatment
Standard Therapies Treatment The treatment of juvenile CLN3 disease is directed toward the specific symptoms that are apparent in each individual. Treatment may require the coordinated efforts of a team of specialists. [rarediseases.org]
Treatment Treatment Options: Treatment is primarily symptomatic for sleep disorders, seizures, psychoses, malnutrition, dystonia and spasticity. [disorders.eyes.arizona.edu]
Management and treatment Treatment is supportive only and should consist of palliative care with administration of anticonvulsive drugs; as well as educational, psychological, and psychiatric management. [orpha.net]
Although there currently is no treatment for this condition, making the correct diagnosis is important for appropriate low-vision management, educational planning, and genetic counseling. [ncbi.nlm.nih.gov]
Prognosis
Prognosis The prognosis for JNCL is severe but life expectancy varies with some patients surviving to the fourth decade. The documents contained in this web site are presented for information purposes only. [orpha.net]
Prognosis Affected children suffer increasing mental impairment, worsening seizures, and progressive loss of sight and motor skills. Eventually, children with Batten disease become blind, bedridden and demented. [brainfoundation.org.au]
Early recognition of cardiac involvement may have led to early intervention with medication but it is difficult to speculate if this would have impacted on his overall morbidity or prognosis. [academic.oup.com]
[…] with early deaths while juvenile and adult onset forms have a relatively better prognosis. [annalsofian.org]
Etiology
Etiology JNCLs are transmitted in an autosomal recessive manner and mutations in the following genes may result in JNCL with a classic and/or variant phenotype: PPT1 (designated CLN1 ; 1p32), TPP1 (11p15; designated CLN2 ), CLN3 (16p12), CLN8 (8p23; responsible [orpha.net]
Neuronal Ceroid Lipofuscinoses: Background, Etiology, Epidemiology [Internet]. [cited 2017 Jun 29]. Available from: http://emedicine.medscape.com/article/1178391-overview Aungaroon G, Hallinan B, Jain P, Horn PS, Spaeth C, Arya R. [eyewiki.aao.org]
Epidemiology
[…] outcome within a decade,and a characteristic fingerprint profile inclusions in different cells,including the variant form with granular osmiophilic deposits (GROD) Relevant External Links for CLN3 Genetic Association Database (GAD) CLN3 Human Genome Epidemiology [genecards.org]
Summary Epidemiology Worldwide prevalence is unknown. [orpha.net]
Screening, diagnosis and epidemiology of Batten disease. Expert Opinion on Orphan Drugs. 2014 Sep 1;2(9):903–10. ↑ Anderson GW, Smith VV, Brooke I, Malone M, Sebire NJ. [eyewiki.aao.org]
Pathophysiology
In Finnish and non-finnish europeans, the estimated frequencies are 1/558 and 1/380, whereas in Latinos and USA it is estimated to be 1/1169 and 1/506. [4] Pathophysiology Genetic The pathophysiology of JNCL has been further elucidated with genetic and [eyewiki.aao.org]
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test Neuronal ceroid lipofuscinoses (NCLs) are a subset of lysosomal storage diseases that involve defective cellular processing of [mayocliniclabs.com]
There were 14 cases where pathophysiological findings suggested LINCL but the specimens had detectable pepinase activity and there were no mutations found. [clinchem.aaccjnls.org]
Prevention
In mice carrying a PPT1 mutation, NtBuHA prevented neuronal cell loss, mitigated behavioral deterioration and increased survival rates. [natureasia.com]
The levels of impairment defined in the table after 369.9 are based on the recommendations of the WHO Study Group on Prevention of Blindness (Geneva, November 6-10, 1972; WHO Technical Report Series 518), and of the International Council of Ophthalmology [genedx.com]
Figure 2 Tunicamycin prevents glycosylation of OS... Figure 5 Immunoprecipitation experiments indicate... Figure 4 The mature form of OSTα is glycosylated ... Figure 3 Membrane expression of OSTα requires the... [sprout038.sprout.yale.edu]
However, these treatments did not prevent the fatal outcome of the disease. Prognosis Affected children suffer increasing mental impairment, worsening seizures, and progressive loss of sight and motor skills. [brainfoundation.org.au]
(19977) NIGMS Human Genetic Cell Repository (10711) ADA Repository (3221) NHGRI Sample Repository for Human Genetic Research (1975) NIA Aging Cell Culture Repository (1503) HD Community Biorepository (179) Autism (73) Centers for Disease Control and Prevention [coriell.org]