Presentation
This disease presents no sex-related differences and it is predominantly found in southern European countries. [elsevier.es]
In addition, in this case, we reported a special case of LINCL as one form of the most fatal PME, to present some special EEG characteristics in details. [journals.lww.com]
The accumulation (storage) of these metabolites occurs because an essential enzyme, needed to further metabolize the accumulated chemicals, is not present or is present in insufficient concentration. [rarediseases.org]
Entire Body System
- Movement Disorder
She is an Associate Editor of ‘Annals of Neurology’ and of ‘Movement Disorders’. [books.google.de]
disorders Rabies Rapid-onset dystonia-parkinsonism Rare choreic movement disorder Rare disorder with dystonia and other neurologic or systemic manifestation Rare dystonia Rare genetic dystonia Rare genetic movement disorder Rare genetic myoclonus Rare [se-atlas.de]
disorders, including dystonia, chorea, myoclonus, tremor and rigidity. [mendelian.co]
A pilot tolerability and efficacy trial of sodium oxybate in ethanolresponsive movement disorders. Mov Disord 2005; 20:1330–1337. CrossRef PubMed Google Scholar 17. Deuschl G, Wilms H. [link.springer.com]
- Hunting
Indications for Test GOSR2 sequencing should be considered for patients with a diagnosis of progressive myoclonic epilepsy (PME), progressive myoclonic ataxia (PMA), or Ramsay Hunt syndrome, especially if they are of Dutch ancestry (van Egmond et al. [preventiongenetics.com]
Cerebellar symptoms were reported in the original description of dyssynergia cerebellaris myoclonica, a mixup of forms of progressive myoclonus epilepsy described by Ramsay Hunt in 1921, but they are not always present in progressive myoclonus epilepsy [medlink.com]
Ramsay-Hunt syndrome is no longer a useful diagnostic category. Movement Disorders 4, 13–17 (1989). 7 Oberle, I. et al. Instability of a 550-basepair DNA segment and abnormal methylation in Fragile X Syndrome. [nature.com]
Psychiat. 56, 150–153 (1920) Google Scholar Hunt, J. R.: Dyssynergia cerebellaris myoclonica-primary atrophy of the dentate system: A contribution to the pathology and symptomatology of the cerebellum. [link.springer.com]
Ramsey-Hunt syndrome. Insomnia. Premenstrual syndrome (PMS). Premenstrual dysphoric disorder (PMDD). Attention deficit-hyperactivity disorder (ADHD). Other conditions. More evidence is needed to rate the effectiveness of 5-HTP for these uses. [webmd.com]
- Wheelchair Bound
Ataxia and myoclonus are progressive with patients becoming wheelchair bound in their early teens. Many EPM6 patients have scoliosis or other skeletal abnormalities. [preventiongenetics.com]
The disease course showed a relentless decline; patients uniformly became wheelchair bound (mean age 13 years) and four had died during their third or early fourth decade. [academic.oup.com]
Neurological examination is initially normal, but patients later develop intention tremor, dysarthria, ataxia and poor coordination, thus subsequently one-third of EPM1 patients become severely incapacitated and wheelchair bound. [journals.plos.org]
Eyes
- Abnormal Eye Movement
KCTD7 mutations have been found in a patient with an atypical clinical presentation characterized by non-epileptic myoclonus and ataxia commencing in early infancy, abnormal opsoclonus-like eye movements, improvement of clinical symptoms under steroid [genecards.org]
Psychiatrical
- Psychomotor Retardation
Anticonvulsant helps little in controlling the seizures and halting the deterioration of psychomotor development. Severe psychomotor retardation is the rule. With time, the disorder may evolve into West syndrome or partial epilepsy. [europeana.eu]
SMARCA2 Nicolaides-Baraitser syndrome SMC1A Congenital muscular hypertrophy-cerebral syndrome SNIP1 Psychomotor retardation, epilepsy, and craniofacial dysmorphism SNX27 Severe myoclonic epilepsy in infancy SPATA5 Epilepsy, hearing loss, and mental retardation [asperbio.com]
retardation syndrome Autosomal recessive cerebellar ataxia-pyramidal signs-nystagmus-oculomotor apraxia syndrome Autosomal recessive cerebellar ataxia-saccadic intrusion syndrome Autosomal recessive cerebelloparenchymal disorder type 3 Autosomal recessive [se-atlas.de]
- Abnormal Behavior
Two patients with adult variant of NCL presented with abnormal behavior and extrapyramidal features. [neurologyindia.com]
Neurologic
- Ataxia
Diseases related with Ataxia and Myoclonus In the following list you will find some of the most common rare diseases related to Ataxia and Myoclonus that can help you solving undiagnosed cases. [mendelian.co]
Autosomal-Recessive Progressive Myoclonus Epilepsy-Ataxia Syndrome age of onset with ataxia at 4–5 years. Myoclonus starts at 5–10 years with a mean at 7 years. Impaired up-gaze. The intellect is usually preserved an neuroimaging studies are normal [slideshare.net]
[…] type 12 Spinocerebellar ataxia type 13 Spinocerebellar ataxia type 14 Spinocerebellar ataxia type 15/16 Spinocerebellar ataxia type 17 Spinocerebellar ataxia type 18 Spinocerebellar ataxia type 19/22 Spinocerebellar ataxia type 2 Spinocerebellar ataxia [se-atlas.de]
Clinical Features Progressive myoclonic epilepsy 6 (EPM6) is a neurological disorder characterized by early onset ataxia and myoclonic seizures. The first symptom of EPM6 is ataxia with onset around 2 years of age. [preventiongenetics.com]
- Generalized Tonic-Clonic Seizure
[…] for about 12 to 14 years in both patients, not only for myoclonus but generalized tonic-clonic seizures as well. [statpearls.com]
Symptoms like stimulus induced myoclonic jerks, cognitive decline and motor slowing, generalized tonic-clonic seizures, or visual/occipital seizures help narrow the diagnosis. [epilepsy.com]
Generalized tonic clonic seizures were documented in all except Patient 2. The average age of onset of generalized tonic clonic seizures was 13.3 years (range 3–24 years; Table 1). [academic.oup.com]
Some affected individuals have generalized tonic-clonic seizures, and rare patients show cognitive decline (summary by De Fusco et al., 2014).For a phenotypic description and a discussion of genetic heterogeneity of familial adult myoclonic epilepsy, [mendelian.co]
- Truncal Ataxia
Other features include mental retardation, dysarthria, truncal ataxia, and loss of fine finger movements. EEG shows slow dysrhythmia, multifocal and occasionally generalized epileptiform discharges. [genecards.org]
The patient presented truncal ataxia, tremor in both hands that could be increased voluntarily, dysarthria, and bilateral dysmetria (finger-to-nose test). [elsevier.es]
Infantile-onset autosomal recessive nonprogressive cerebellar ataxia Infectious disease of the nervous system Infectious encephalitis Inherited Creutzfeldt-Jakob disease Intellectual disability-hyperkinetic movement-truncal ataxia syndrome Intermediate [se-atlas.de]
- Atonic Seizures
[…] of consciousness May be seen as component of other seizures Absence seizures often have an atonic component Myoclonic jerk may precede or accompany the seizure Long seizures cause seconds of flaccid paralysis EEG: poly spike and wave or generalized spike [neurodiffdx.com]
Generalized-onset seizure Generalized myoclonic seizures Hand tremor Cortical myoclonus Focal-onset seizure Abnormality of movement Delayed speech and language development Chorea Dystonia Anxiety Dysmetria Atonic seizures Blepharospasm Sensory axonal [mendelian.co]
- Drop Attacks
Myoclonic seizures begin in early childhood, and patients exhibit multiple seizure types including: generalized tonic clonic seizures, absence seizures, and drop attacks. [preventiongenetics.com]
Patients 1, 2, 4 and 7 had drop attacks beginning around the age of 13 or 14 years. Generalized tonic clonic seizures were documented in all except Patient 2. [academic.oup.com]
Characteristically, visual seizures are the first manifestation, followed by generalized tonic–clonic seizures, absences, or drop attacks. Visual seizures present as transient blindness, simple or complex visual hallucinations. Myoclonus is often [slideshare.net]
Workup
DIAGNOSTIC WORKUP In the initial stage of Ohtahara syndrome, interictal EEG shows a pattern of suppression-burst with high-voltage paroxysmal discharges separated by prolonged periods of nearly flat tracing that last for up to 18 seconds. [europeana.eu]
EEG
- Generalized Epileptiform Discharges
EEG shows slow dysrhythmia, multifocal and occasionally generalized epileptiform discharges. [genecards.org]
Generalized epileptiform discharges in 84.2% of patients, while focal discharges were present in ten patients. One of the patient had multifocal epileptiform activity. [neurologyindia.com]
Figure 3 EEG showing generalized epileptiform discharges on a slow background. EEG from Patient 6 (bipolar montage) showing generalized spike and slow wave discharges with an occipital predominance on a slow background. [academic.oup.com]
- EEG Slowing
slow background with generalised spike and wave. Epileptiform abnormalities are accentuated during sleep but not with photic stimulation. The gene associated with this disease, CLN3, is located on the short arm of chromosome 16. 20. [slideshare.net]
Treatment
Brand-new chapters in the drug and diet section cover perampanel, ezogabine, and lacosamide, while the existing chapters on major medical treatments have been comprehensively updated to reflect the latest trials and studies. [books.google.de]
Lamotrigine was noted as an effective treatment for infantile and juvenile neuronal ceroid lipofuscinosis. [statpearls.com]
So far, the treatment of PMEs remains symptomatic (i.e. pharmacological treatment of myoclonus and seizures), since there is no etiologic treatment for most PMEs. Pharmacological treatment of PMEs usually relies on a combination of ≥ 2 AEDs [2]. [ncbi.nlm.nih.gov]
Treatment-emergent adverse events affecting >10% of patients in the pivotal studies were dizziness, headache and somnolence. [ots.at]
Prognosis
However, the female patient has a poor prognosis. In the following visit, she has serious sleep problems, such as sleep fragment and insomnia due to her sensitivity to the light and voice. [journals.lww.com]
PROGNOSIS AND THREATMENT Half of the reported children having Ohtahara syndrome die in infancy. Anticonvulsant helps little in controlling the seizures and halting the deterioration of psychomotor development. [europeana.eu]
In patients with Unverricht-Lundborg disease or with mitochondrial encephalomyopathy with ragged red fibers the prognosis is slightly better but highly variable. 20 Though the prognosis in PME remains poor, progression is nowadays much slower and life [jamanetwork.com]
Activities/Hipokampal Skleroz Olgularinda Olagan Disi Epileptik Aktivitelerin Arastirilmasi Authors : Yavuz, Ebru Nur Vanli; Yener, Hakan; Ozemir, Zeynep Aydin Subjects: Electroencephalography -- Usage; Electroencephalography -- Analysis; Sclerosis -- Prognosis [library.essextech.net]
Etiology
Recently, PMEs have been recognized as a group of syndromes with specific etiologies. However, few studies demonstrated the EEG changes in PME in details. [journals.lww.com]
Despite increasing knowledge of the etiology of most progressive myoclonus epilepsy disorders, the pathogenic mechanisms leading to neurodegeneration and epilepsy remain largely unknown. • Histological and/or genetic studies are frequently required to [medlink.com]
Limited efficacy of levetiracetam on myoclonus of different etiologies. Parkinsonism Relat Disord. 2005;11:135–7. [PubMed] [Google Scholar] 36. Mancuso M, Galli R, Pizzanelli C, Filosto M, Siciliano G, Murri L. [ncbi.nlm.nih.gov]
Over the last two decades, considerable developments have occurred in the field of PMEs and they have been recognized as a group of syndromes with specific etiologies. [2],[3],[4] Genetic tests had further enhanced the understanding of the disease process [neurologyindia.com]
Epidemiology
From basic mechanisms and epidemiology, through diagnosis and therapy, to quality of life issues, the new edition of this established reference covers every aspect of childhood epilepsy and will continue to be the definitive core text for all professionals [books.google.de]
Epidemiology[edit] PME accounts for less than 1% of epilepsy cases at specialist centres. [en.wikipedia.org]
Pathophysiology
But recognizing the phenomenology and understanding the pathophysiology are essential to ensure appropriate treatment. Hyperkinetic Movement Disorders provides a clinical pathway for effective diagnosis and management of these disorders. [books.google.de]
Impaired attention, genetics, and the pathophysiology of schizophrenia. [books.google.ro]
The nosology and pathophysiology of myoclonus. Mov Disord 1982:196–248. Google Scholar 2. Fahn S, Marsden CD, Van Woert MH. Definition and classification of myoclonus. Adv Neurol 1986; 43:1–5. PubMed Google Scholar 3. Nirenberg MJ, Frucht SJ. [link.springer.com]
Gaucher disease: the metabolic defect, pathophysiology, phenotypes and natural history. Pediatr Endocrinol Rev 2014; 12 (Suppl. 01) 72-81 37 Park JK, Orvisky E, Tayebi N, et al. [thieme-connect.com]
Our results indicate that the changes in both the thalamus and putamen may play an important role in the pathophysiology of EPM1. Further studies in larger patient materials will show whether 3D TA could be a relevant tool for clinical applications. [journals.plos.org]
Prevention
Collaborative Meta-Analysis of Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke in High Risk Patients. [books.google.es]
Mutations in the EPM2A gene prevent cells from making functional laforin, while NHLRC1 gene mutations prevent the production of functional malin. It is unclear how a loss of either of these proteins leads to the formation of Lafora bodies. [ghr.nlm.nih.gov]
As a result, laforin or malin deficiency would prevent digestion of polyglucosans and result in their accumulation (Figure 5B).[16] Figure 5. Two recent theories of the pathogenesis of Lafora bodies. [medscape.com]
Supplemental Content Recent activity Clear Turn Off Turn On Treatment and prevention of herpes labialis Treatment and prevention of herpes labialis Canadian Family Physician. 2008 Dec; 54(12)1683 Struma ovarii: management and follow-up of a rare ovarian [ncbi.nlm.nih.gov]