Presentation
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]
This disease presents no sex-related differences and it is predominantly found in southern European countries. [elsevier.es]
The gene, denoted EPM2, presents alternative splicing in the 5' and 3' end regions. Mutational analysis revealed that EPM2 patients are homozygous for loss-of-function mutations in EPM2. [moh-it.pure.elsevier.com]
Gastrointestinal bleeding due to portal hypertension might be the presenting symptom in adolescents or young adults. [orpha.net]
Entire Body System
- Movement Disorder
Neurologists should be aware of this rare form of PME, its phenotypical variability, including ataxia and other movement disorders apart from myoclonus. Further clinical and molecular descriptions of this entity are needed. Table 1. [onlinelibrary.wiley.com]
Movement disorders in autoimmune diseases. Mov Disord. 2012;27(8):935-46. Baizabal-Carvallo JF, Jankovic J. Parkinsonism, movement disorders and genetics in frontotemporal dementia. Nat Rev Neurol. 2016;12(3):175-85. [bcm.edu]
Preview https://doi.org/10.1002/mds.23813 Movement Disorders : Official Journal of the Movement Disorder Society; Danner N, Säisänen L et. al. [allmedx.com]
- Pain
antibodies, etc and Supportive cancer therapies; pain relief, nausea, etc - Vascular/Immunological Reaction: Acute coronary syndrome, atherothrombotic disease, sepsis, rheumatoid arthritis, psoriasis, Crohn's disease, etc With operations in the U.S. [ots.at]
Its main symptoms are: painful muscle spasms, diarrhea, alopecia and skeletal abnormalities. Cl... [ojrd.biomedcentral.com]
The parietal lobe, located near the center of the brain, is responsible for processing information about the sense of touch, pain, and space. Parietal lobe epilepsy may result from head trauma, birth injury, stroke, tumor, or unknown causes. [nyulangone.org]
Hypokalemic periodic paralysis type 1 CACNA1S Hypomyelination with brainstem and spinal cord involvement and leg spasticity DARS Inclusion body myopathy GNE Inclusion body myopathy MYH2 Infantile neuroaxonal dystrophy type 1 PLA2G6 Insensitivity to pain [centogene.com]
- Multiple Congenital Anomalies
congenital anomalies-hypotonia-seizures syndrome 1 multiple congenital anomalies-hypotonia-seizures syndrome 3 multiple epiphyseal dysplasia 4 multiple epiphyseal dysplasia 7 multiple intestinal atresia multiple mitochondrial dysfunctions syndrome 1 [rgd.mcw.edu]
congenital anomalies-hypotonia-seizures syndrome type 3 PIGT Multiple mitochondrial dysfunctions syndrome type 1 NFU1 Multiple mitochondrial dysfunctions syndrome type 2 BOLA3 Multiple mitochondrial dysfunctions syndrome type 3 IBA57 Multiple mitochondrial [centogene.com]
Gastrointestinal
- Overeating
He has also published over 50 articles in Greek. He has been the invited author of over 44 chapters in neurology books. [books.google.com]
These diseases share certain features, including a worsening of symptoms over time and the presence of both muscle contractions (myoclonus) and seizures (epilepsy). PME is different from myoclonic epilepsy. [diseaseinfosearch.org]
Compared to JME, they do not respond well to medications and get worse over time. Generalized tonic-clonic seizures are also common in PME. [epilepsy.com]
During the trials, patients were randomised to various dosages of Zebinix or placebo and after a 2-week titration period, were assessed over a 12-week maintenance period, with continued follow-up over a one year open-label period. [ots.at]
Over 15 specific disorders can cause the PME syndrome; all are rare, and individual physicians are unlikely to have experience in all of them. Accurate diagnosis is essential to provide a prognosis, optimal therapy, and genetic counseling. [journals.lww.com]
Neurologic
- Dystonia
Other features include dementia, dystonia, and trouble walking or speaking. These rare disorders often get worse over time and sometimes are fatal. Many of these PME diseases begin in childhood or adolescence. [diseaseinfosearch.org]
It typically starts in childhood with myoclonic jerks and usually is seen in combination with mild dystonia (abnormal postures). [bcm.edu]
16 dystonia 27 dystonia 5 Dystonia Musculorum Deformans + early-onset myopathy-areflexia-respiratory distress-dysphagia syndrome EAST syndrome ectodermal dysplasia 10B ectodermal dysplasia 11B ectodermal dysplasia 13 ectodermal dysplasia 14 ectodermal [rgd.mcw.edu]
[…] juvenile-onset ACTB Dystonia, DOPA-responsive, autosomanl recessive SPR Dystonia-deafness syndrome TIMM8A DYT1 TOR1A DYT2 HPCA DYT3 TAF1 DYT4 TUBB4A DYT5A GCH1 DYT6 THAP1 DYT8 SLC2A1 DYT10 PRRT2 DYT11, DRD2 related DRD2 DYT11 SGCE DYT12 ATP1A3 DYT16 [centogene.com]
Furthermore, considering that our case has mixed movement disorders, including mild choreoathetosis and dystonia associated with ataxia and myoclonus, additional possible diagnosis should include ataxia telangiectasia, TUBB4A mutations, and aprataxin [onlinelibrary.wiley.com]
- Chorea
G25.5 기타 무도병(Other chorea) 무도병(Chorea) NOS 제외:심장침습을 동반한 무도병(chorea with heart involvement) NOS(I02.0) 헌팅톤 무도병(Huntington's chorea)(G10) 류마티스성 무도병(rheumatic chorea)(I02.-) 시덴함 무도병(Sydenham's chorea)(I02.-) G25.6 약물유발성 틱 및 기질적 원인의 틱(Drug-induced tics and [dic.impact.pe.kr]
Leber hereditary optic neuropathy with chorea and dementia resembling Huntington disease. Neurology 2004;63:2451-2452. 9. Riordan-Eva P. Neuro-ophthalmology of mitochondrial diseases. Curr Opin Ophthalmol 2000;11:408-412. 10. Flanigan KM, Johns DR. [docsplayer.org]
[…] juvenile NCL death occurs by 15-25 years, whereas the adult group has a variable course. [1],[8],[32],[37] The presenting clinical features in infantile NCL, late infantile NCL, and juvenile NCL group were regression of milestones, seizures, myoclonus, chorea [neurologyindia.com]
APP related APP Cerebral palsy type 1, spastic quadriplegic GAD1 Cerebral palsy type 2, spastic quadriplegic KANK1 Cerebrotendinous xanthomatosis CYP27A1 Cervical dystonia CIZ1 Charcot-Marie-Tooth disease, axonal type 20 DYNC1H1 CHILD syndrome NSDHL Chorea [centogene.com]
- Tremulousness
AbstractEight cases of Orzechowski syndrome are reported.Its menifestation include opsoclonus,body tremulousness and benign encephalitis.They were followed up for an average 34±0.5 months.The results indicated that the prognosis was benign. [dict.cnki.net]
- Language Delays
delay due to deafness)(H90-H91) 정신 발육지체(mental retardation)(F70-F79) F80.3 간질에 의한 후천성 실어증[란다우-클레프너](Acquired aphasia with epilepsy [Landau-Kleffner]) 정상 언어발달을 보이던 아동이 수용형, 표현형 언어 숙련도를 상실하나 전반적 지적능력은 유지된 다. [dic.impact.pe.kr]
- Alteration of Consciousness
[…] with complex partial seizures) 간혹 자동증을 동반하며 의식의 변화가 있는 발작(Attacks with alteration of consciousness, often with automatisms) 속발성 전신발작으로 진행하는 복합성 부분발작(Complex partial seizures developing into secondarily generalized seizures) G40.3 전신성 특발성 간질 및 간질성 증후군 [dic.impact.pe.kr]
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
- Photoparoxysmal Response
Intermittent light stimulation generated a photoparoxysmal response at low frequencies. Epileptic activity did not increase during stages of drowsiness. [elsevier.es]
With doses of up to 10 g/day, elimination of photoparoxysmal responses was achieved in all 3 patients. [karger.com]
response Negative 6 and 20 Hz provoked a photoparoxysmal response Negative Brain MRI Mild atrophy of the cerebellum and brainstem Not available Not available Not available Brainstem atrophy particularly in the pons Treatment VPA VPA VPA VPA LEV, CNZ, [onlinelibrary.wiley.com]
Treatment
Treatment-emergent adverse events affecting >10% of patients in the pivotal studies were dizziness, headache and somnolence. [ots.at]
The precise etiology is important when determining the best course of treatment. Response to treatment is variable and usually depends on the epileptic syndrome. [tandfonline.com]
The medical treatment of progressive myoclonic epilepsy is limited to supportive and symptomatic treatment. The treatment is often successful only for a few months or years. There is no current cure for PME. [epilepsy.com]
Therefore new treatment modalities are needed. Experimental treatments of ULD patients with dopamine agonists have relieved myoclonic symptoms. [clinicaltrials.gov]
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]
What is the prognosis for patients with Lafora disease? At this time, the prognosis for persons affected by Lafora disease is, unfortunately, poor. [epilepsy.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]
Each of these progressive myoclonic epilepsy syndromes produces a collection of signs and symptoms as well as a characteristic progression and prognosis. [verywellhealth.com]
Etiology
The precise etiology is important when determining the best course of treatment. Response to treatment is variable and usually depends on the epileptic syndrome. [tandfonline.com]
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]
They are organised into groups, and further divided into clinical, etiological or histopathological sub-types. [orpha.net]
Epidemiology
Summary Epidemiology Estimated prevalence at birth of PFIC types 1-3 varies between 1/50,000 and 1/100,000. PFIC3 represents one third of PFIC cases. [orpha.net]
Epidemiology of the mitochondrial DNA 8344A > G mutation for the myoclonus epilepsy and ragged red fibres (MERRF) syndrome. J Neurol Neurosurg Psychiatry 2003; 74: 1158–1159. PubMed CrossRef Google Scholar 9. DeVivo DC, DiMauro S. [link.springer.com]
Epidemiology[edit] PME accounts for less than 1% of epilepsy cases at specialist centres. [en.wikipedia.org]
Epidemiology of Severe Myoclonic Epilepsy of Infancy. Epilepsia. August 1990, 31 (4): 397–400. PMID 1695145. doi:10.1111/j.1528-1157.1990.tb05494.x. ^ Yakoub, M; Dulac, O; Jambaqué, I; Chiron, C; Plouin, P. [zh.wikipedia.org]
Epidemiology PMEs account for 46 Series from different countries reveal considerable geographic and ethnic variability in the occurrence of specific types of PMEs. 1, 36, 40, 46 Details of known geographic clusters of specific PMEs are given below. [neupsykey.com]
Pathophysiology
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]
Etiology and pathophysiology 3.1. PFIC 1 (ATP8B1 "FIC-1" deficiency) PFIC1 is an autosomal recessive disease caused by mutations in ATP8B1 (formerly named FIC1) gene on chromosome 18, locus q21-22. [intechopen.com]
Prevention
N-acetylcysteine (NAC) is a sulfhydryl antioxidant that increases cellular glutathione and the activity levels of several antioxidant enzymes and has additional actions that contribute to its demonstrated efficacy in preventing or decreasing damage in [neurology.org]
Is chronic lung disease in low birth weight infants preventable? A survey of eight centers. Página 84 - Tanner JM, Whitehouse RH, Marubini E, Resele LF. The adolescent growth spurt of boys and girls of the Harpenden growth study. [books.google.es]
[…] protein C sv Här i parlamentet finns en tvärpolitisk grupp för Östersjön och Europa som träffas en gång i månaden i Strasbourg och som jag har äran att vara ordförande i. en Replacement of protein C in protein C deficient patients should control or prevent [sv.glosbe.com]
Management and treatment Ursodeoxycholic acid therapy (UDCA) should be initiated in all patients to prevent liver damage. Beneficial effects of UDCA are usually observed in patients who harbored at least one missense mutation. [orpha.net]
The protein may be involved in the control of glycogen metabolism, particularly in monitoring for and preventing the formation of poorly branched glycogen molecules. [antibodies-online.com]