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Sensory Ataxic Neuropathy - Dysarthria - Ophthalmoparesis Syndrome

SANDO


Presentation

  • Neuromuscular syndromes are presented clinically either as a case study or as an overview from the literature, accompanied by text presenting molecular defects, and differential diagnosis.[books.google.de]
  • Recessive POLG mutations presenting with sensory and ataxic neuropathy in compound heterozygote patients with progressive external ophthalmoplegia. Neuromusc Disord. 2003;13:133–42. PubMed CrossRef Google Scholar 5.[link.springer.com]
  • The documents contained in this web site are presented for information purposes only. The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment.[orpha.net]
Movement Disorder
  • Diagnostic challenges in movement disorders: Sensory Ataxia Neuropathy Dysarthria and Ophthalmoplegia (SANDO) syndrome Alyson Lovan , Ihtsham ul Haq , Nikhil Balakrishnan Department of Neurology , Wake Forest Baptist Health, Winston Salem, North Carolina[casereports.bmj.com]
  • Case Studies in Movement Disorders Online ISBN: 9781316145050 Book DOI: Hanisch, F, Kornhuber, M, Alston, CL, Taylor, RW, Deschauer, M, Zierz, S. SANDO syndrome in a cohort of 107 patients with CPEO and mitochondrial DNA deletions.[cambridge.org]
  • Neurological investigation revealed an external ophthalmeplegia and a cerebellar ataxia ; the head impulse test was not reliable because of eye movement disorders.[journals.lww.com]
  • disorders Chorea DRPLA , 17 1 (Late stage) Myoclonus DRPLA 2 , 19 Tremor 2 , 8 , 12 15 , 21 , 27 Parkinsonism 3 , 9 , 12 , 17 2 , 21 Dystonia 3 17 Ocular disorders Ophthalmoplegia 3 , 2 , 1 , 9 Nystagmus 1 , 3 , 6 Slow saccades 2 1 , 3 , 7 , 17 Pigmentary[neuromuscular.wustl.edu]
Physician
  • Genetic Neuromuscular Disorders: A Case-Based Approach is aimed at neuromuscular physicians and neurology residents.[books.google.de]
  • This information is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.[diseaseinfosearch.org]
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers.[rarediseases.info.nih.gov]
  • Some physicians will treat with a vitamin cocktail, but this is decided on an individual basis (see also below).[clinicaladvisor.com]
  • Ophthalmological Society, Canadian Society of Oculoplastic Surgery, Chinese Canadian Medical Society, European Society of Ophthalmic Plastic and Reconstructive Surgery, North American Neuro-Ophthalmology Society, Ontario Medical Association, Royal College of Physicians[emedicine.medscape.com]
Progressive Ophthalmoplegia
  • ophthalmoplegia Homonymous hemianopia Micrognathia Abnormal facial shape Feeding difficulties Delayed speech and language development Myopia Infantile onset Abnormality of the skeletal system Short nose Delayed skeletal maturation Absent speech Dyschromatopsia[mendelian.co]
  • Twinkle mutation in an Italian family with external progressive ophthalmoplegia and parkinsonism: A case report and an update on the state of art. Neurosci.[mdpi.com]
Erythema
  • The most common early neurologic manifestations are aseptic meningitis, meningoencephalitis following erythema migrans by 2-10 weeks, often associated with cranial neuropathy, motor or sensory polyradiculoneuritis (typically cauda equina neuritis) and[neuroweb.us]
Blurred Vision
Long Arm
  • The POLG1 gene is located on the long arm of chromosome 15 (more precise localisation: 15q25). So far, 135 mutations in the POLG1 gene have been identified (The Human Gene Database, as of 09.2010).[labor-lademannbogen.de]
Hearing Impairment
  • impairment Sensorineural hearing impairment Ptosis Cataract SOURCES: UMLS MONDO OMIM ORPHANET More info about PROGRESSIVE EXTERNAL OPHTHALMOPLEGIA WITH MITOCHONDRIAL DNA DELETIONS, AUTOSOMAL RECESSIVE 4; PEOB4 Low match CHARCOT-MARIE-TOOTH DISEASE, X-LINKED[mendelian.co]
  • Showing of 45 30%-79% of people have these symptoms Abnormal morphology of the cerebellar cortex 0031422 Abnormal thalamic MRI signal intensity 0012696 Atrophy/Degeneration involving the spinal cord 0007344 Bilateral sensorineural hearing impairment 0008619[rarediseases.info.nih.gov]
  • Impairment Noonan Syndrome Noonan Syndrome 3 Noonan Syndrome, LEOPARD Syndrome Normal Tension Glaucoma Norrie Disease Nucleoside Phosphorylase Deficiency Obesity, Hyperphagia, and Developmental Delay Obesity, Severe Obesity, Morbid, with Hypogonadism[sequencing.com]
  • Mutations in KARS, encoding lysyl-tRNA synthetase, cause autosomal-recessive nonsyndromic hearing impairment DFNB89. American Journal of Human Genetics 93, 132-140.[mitomap.org]
Suggestibility
  • Key points for each genetic disease are identified to suggest treatment, when available, or the main clinical exams useful in follow-up of patients.[books.google.de]
  • Genetic counseling Autosomal recessive and dominant inheritance, as well as sporadic occurrence, have been suggested. The documents contained in this web site are presented for information purposes only.[orpha.net]
  • Diagnosing MIDs A MID was diagnosed as “definite” MID if the clinical manifestations suggested a MID and if there was biochemical or genetic evidence of a mitochondrial defect.[omicsonline.org]
  • Chronic immune sensory polyradiculopathy • NCS normal, but somatosensory-evoked potentials are abnormal, suggesting sensory root involvement • MRI Lumbar spine may show enlarged and enhancing nerve roots • CSF may show raised protein • Sensory rootlet[slideshare.net]
Dysarthria
  • […] of SANDO syndrome or SANDO syndrome like conditions General notes Sensory ataxic neuropathy, dysarthria, and ophthalmoplegia (SANDO syndrome) is caused by mutations in the POLG1 and C10orf2 genes.[labor-lademannbogen.de]
  • Genetic testing revealed a compound heterozygous mutation in the POLG1 gene consistent with the diagnosis of Sensory Ataxia Neuropathy Dysarthria and Ophthalmoplegia (SANDO) syndrome.[casereports.bmj.com]
  • Disease definition Sensory ataxic neuropathy-dysarthria-ophthalmoparesis syndrome is characterised by adult-onset severe sensory ataxic neuropathy, dysarthria and chronic progressive external ophthalmoplegia.[orpha.net]
Chronic Progressive External Ophthalmoplegia
  • Disease definition Sensory ataxic neuropathy-dysarthria-ophthalmoparesis syndrome is characterised by adult-onset severe sensory ataxic neuropathy, dysarthria and chronic progressive external ophthalmoplegia.[orpha.net]
  • progressive external ophthalmoplegia, which results from mitochondrial dysfunction and is due to mtDNA depletion in muscle and peripheral nerve.[link.springer.com]
  • Chronic progressive external ophthalmoplegia. Current Ocular Therapy. 5th ed. 2000. 208-210. Galetta F, Franzoni F, Mancuso M, Orsucci D, Tocchini L, Papi R, et al. Cardiac involvement in chronic progressive external ophthalmoplegia.[emedicine.medscape.com]
Polyneuropathy
  • Nerve conduction studies found a severe sensorimotor axonal polyneuropathy.[casereports.bmj.com]
  • Reviewing the full spectrum of clinically significant neuropathies, the book contains chapterson common and rare forms including mononeuropathy in the upper and lower extremities, mononeuritismultiplex, diffuse and symmetric polyneuropathies, brachial[books.google.com]
  • POLG mutations causing ophthalmoplegia, sensorimotor polyneuropathy, ataxia, and deafness. Neurology. 2004;62:316–8. PubMed CrossRef Google Scholar 3. Winterthun S, Ferrari G, He L, Taylor RW, Zeviani M, Turnbull DM, Engelsen BA, Moen G, Bindoff LA.[link.springer.com]
Chronic Progressive External Ophthalmoplegia
  • Disease definition Sensory ataxic neuropathy-dysarthria-ophthalmoparesis syndrome is characterised by adult-onset severe sensory ataxic neuropathy, dysarthria and chronic progressive external ophthalmoplegia.[orpha.net]
  • progressive external ophthalmoplegia, which results from mitochondrial dysfunction and is due to mtDNA depletion in muscle and peripheral nerve.[link.springer.com]
  • Chronic progressive external ophthalmoplegia. Current Ocular Therapy. 5th ed. 2000. 208-210. Galetta F, Franzoni F, Mancuso M, Orsucci D, Tocchini L, Papi R, et al. Cardiac involvement in chronic progressive external ophthalmoplegia.[emedicine.medscape.com]
Headache
  • Adult Phenotypic Spectrum of Headache, Myopathy and Ischemic Stroke Associated with Mitochondrial POLG Mutation. Austin J Cerebrovasc Dis & Stroke. 2014;1(5): 1021. ISSN: 2381-9103.[austinpublishinggroup.com]
  • Migraine headache Migraine headaches [ more ] 0002076 Seizures Seizure 0001250 Percent of people who have these symptoms is not available through HPO Adult onset Symptoms begin in adulthood 0003581 Autosomal recessive inheritance 0000007 Cognitive impairment[rarediseases.info.nih.gov]
  • Spinocerebellar ataxia with epilepsy (SCAE) is a similar disorder with a higher frequency of migraine headaches and seizures ({13:Winterthun et al., 2005}).[diseaseinfosearch.org]
  • Initial symptoms may include stroke-like episodes, seizures, migraine headaches, and recurrent vomiting.[rarediseasesnetwork.org]
  • […] can include myopathy, seizures, and hearing loss, but the common clinical feature appears to be sensory ataxia (review by Milone and Massie, 2010 ).Spinocerebellar ataxia with epilepsy (SCAE) is a similar disorder with a higher frequency of migraine headaches[mendelian.co]

Workup

  • Hypercoagulable state workup and 28-day prolonged cardiac monitoring were negative. She had sixteen pregnancies and five live births.[austinpublishinggroup.com]
  • • History of diabetes mellitus and alcohol excess (both common causes of neuropathy) do not preclude the possibility of coexisting pathology • Serum immunoelectrophoresis and immunofixation are, therefore, important investigations in the diagnostic workup[slideshare.net]

Treatment

  • Key points for each genetic disease are identified to suggest treatment, when available, or the main clinical exams useful in follow-up of patients.[books.google.de]
  • The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment.[orpha.net]
  • The textbookprovides an evidence-based approach to testing, differential diagnosis, and treatment, and should serveas a trusted resource for healthcare professionals confronting the many manifestations of peripheralneuropathy in clinical practice.[books.google.com]

Prognosis

  • The prognosis for Leigh syndrome is poor. Depending on the defect, individuals typically live a few years.[rarediseasesnetwork.org]
  • Glucose Tests * Home Urine Ketone Tests * Home Diabetes HbA1c Tests * Home Microalbumin Tests (Kidney) * Home Urine Protein Tests (Kidney) * Home Kidney Tests * Home Eye Tests * Vision & Eye Health: Home Testing: * Home Eye Tests * Home Vision Tests Prognosis[checkorphan.org]
  • The MTTL1 gene is most often associated with the mitochondrial inheritance pattern, along with other mtRNA and mtDNA genes. [14] Prognosis The prognosis is guarded with a generally progressive disorder.[emedicine.medscape.com]
  • Favorable prognosis is indicated by preserved action potential preserved R1 or reappearance of R1 after 3 weeks. About 15% of patients will have permanent sequelae.[neuroweb.us]
  • The prognosis of LS is poor, especially in infancy-onset disease, as most children will die in the first years of life.[clinicaladvisor.com]

Etiology

  • Etiology The syndrome is associated with mitochondrial DNA mutations in either the POLG1 or TWINKLE genes. Genetic counseling Autosomal recessive and dominant inheritance, as well as sporadic occurrence, have been suggested.[orpha.net]
  • Lee YM, Kang HC, Lee JS, Kim SH, Kim EY, et al. (2008) Mitochondrial respiratory chain defects: underlying etiology in various epileptic conditions. Epilepsia 49: 685-690.[omicsonline.org]

Epidemiology

  • Summary Epidemiology The prevalence is unknown.[orpha.net]
  • Epidemiology The prevalence is unknown.[rarediseases.info.nih.gov]
  • Josef Finsterer 1 * and Sinda Zarrouk-Mahjoub 2 1 Krankenanstalt Rudolfstiftung, Vienna, Austria 2 Genetics Laboratory, Research Unit “Genetics Epidemiology and Molecular” Faculty of Medicine Tunis, Tunisia Corresponding Author : Josef Finsterer Krankenanstalt[omicsonline.org]
  • The balance of oxidative demands of a given tissue and the proportion of deleted mtDNA it contains will ultimately determine whether the tissue is affected clinically. [12] Epidemiology Frequency Worldwide Worldwide, the prevalence of mitochondrial disease[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Mitochondrial DNA (mtDNA) encodes for essential components of the respiratory chain.[emedicine.medscape.com]
  • […] article is freely available re-usable Review Genes and Pathways Involved in Adult Onset Disorders Featuring Muscle Mitochondrial DNA Instability Neurology Unit, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Dino Ferrari Centre, Department of Pathophysiology[mdpi.com]

Prevention

  • To help explain this effect we determined that the G451E p55 heterodimer has a weakened ability to bind to p140 which prevents polγ from incorporating the normal amount of DNA building blocks (nucleotides) into newly synthesized DNA.[atlasofscience.org]
  • Prevention - Sensory ataxic neuropathy- dysarthria- and ophthalmoparesis Not supplied.[checkorphan.org]
  • Supportive treatment and prevention of further damage from UV light is the mainstay of treatment for dermatological manifestations of XP and DCS. Effective treatment for neurological manifestations of these disorders is not available.[karger.com]
  • How can mitochondrial disorders be prevented? Since this is a genetically determined disorder, there is no prevention. Prevention of stressors that exacerbate the condition, such as illness, is advocated for all mitochondrial disease.[clinicaladvisor.com]
  • Treatment for the neuritis and nerve function impairment includes corticosteroids which are used to prevent further damage and facilitate recovery.[neuroweb.us]

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