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Sensory Ataxic Neuropathy - Dysarthria - Ophthalmoparesis Syndrome

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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]
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]
  • arm of chromosome 1 Partial deletion of the long arm of chromosome 22 Partial deletion of the short arm of chromosome 4 Partial duplication of the short arm of chromosome 4 Patent foramen ovale Perinatal lethal hypophosphatasia Perineural cyst Periodic[sanfordresearch.org]
Positive Romberg Sign
  • Romberg sign * Depression * Dysphagia * Nystagmus * Reduced position sense * Mild cognitive impairment * Reduced vibration sense * Balance problems * Frequent falls * Muscle weakness * Gastroparesis * Weight loss * Enlarged heart * Stupor * Eye movement[checkorphan.org]
  • Sensory ataxia is distinguished from cerebellar ataxia by the presence of near-normal coordination when the movement is visually observed by the patient, but marked worsening of coordination when the eyes are shut, indicating a positive Romberg's sign[en.wikipedia.org]
  • Romberg sign 0002403 Progressive external ophthalmoplegia 0000590 Progressive gait ataxia 0007240 Proximal muscle weakness 0003701 Ptosis Drooping upper eyelid 0000508 Ragged-red muscle fibers 0003200 Seizures Seizure 0001250 Sensorineural hearing impairment[rarediseases.info.nih.gov]
  • romberg sign 64 65.[slideshare.net]
  • Romberg sign 10% Vestibular dysfunction 10% Mildly elevated creatine phosphokinase 10% Migraine 10% Dilated cardiomyopathy 10% Myoclonus 10% Parkinsonism with favorable response to dopaminergic medication 10% Testicular atrophy 10% Secondary amenorrhea[mendelian.co]
Areflexia
  • Sensory Ataxic form of CIDP • Uncommon • Manifests as prominent numbness in the extremities, ataxia, areflexia and impaired vibration and/or joint position sense • Weakness may be mild or absent 27 28.[slideshare.net]
  • Other compounds: Carbon disulphide : In rubber vulcanization, distal sensorimotor loss and areflexia affecting the legs.[neuroweb.us]
  • Showing of 35 5%-29% of people have these symptoms Cataract Cloudy lens 0000518 Percent of people who have these symptoms is not available through HPO Adult onset 0003581 Areflexia 0001284 Atrophy/Degeneration involving the spinal cord 0007344 Autosomal[rarediseases.info.nih.gov]
  • Peripheral demyelination 20% Cardiomyopathy 20% Hypogonadotrophic hypogonadism 20% Motor axonal neuropathy 20% Gait disturbance 20% Ventriculomegaly 20% Global developmental delay 20% Intellectual disability 20% Muscle fiber necrosis 20% Seizures 20% Areflexia[mendelian.co]
  • […] malformation Capillary malformation - arteriovenous malformation Cat-scratch disease Cardiofaciocutaneous syndrome Celiac disease, epilepsy and cerebral calcification syndrome Central areolar choroidal dystrophy Central precocious puberty Cerebellar ataxia - areflexia[sanfordresearch.org]
Absent Deep Tendon Reflex
  • Clinical description Other common features include progressive gait unsteadiness, absent deep tendon reflexes, the presence of Romberg's sign, a decreased sense of vibration and proprioception and detection of red ragged fibres on muscle biopsy.[orpha.net]
  • The phenotype is largely variable: The common clinical feature appears to be sensory ataxia, and other symptoms include myopathy, seizures, hearing loss, progressive gait unsteadiness, absent deep tendon reflexes, Romberg’s sign, decreased sense of vibration[link.springer.com]
  • Clinical description Other common features include progressive gait unsteadiness, absent deep tendon reflexes, the presence of Romberg's sign, a decreased sense of vibration and proprioception and detection of red ragged fibres on muscle biopsy .[rarediseases.info.nih.gov]
Hyporeflexia
  • […] impairment Mental impairment [ more ] 0100543 Cytochrome C oxidase-negative muscle fibers 0003688 Depressivity Depression 0000716 Dilated cardiomyopathy 0001644 Dysarthria Difficulty articulating speech 0001260 Gastroparesis Delayed gastric emptying 0002578 Hyporeflexia[rarediseases.info.nih.gov]
  • Autosomal recessive inheritance 30% Nystagmus 30% Try adding any of this symptoms in our app Other less frequent symptoms Patients with Cataract and Peripheral axonal neuropathy. may also develop some of the following symptoms: 30% Ptosis 30% Dysarthria 30% Hyporeflexia[mendelian.co]
  • DDs Of Sensory Ataxia 21 Secondary To Peripheral Neuropathies Paresthesia, tingling, Pseudocramp Symmetrical distal sensory loss Areflexia or hyporeflexia Weakness, if present, symmetrical When the neuropathy is primarily demyelinating rather than[slideshare.net]
  • The clinical presentation is that of progressive/relapsing and remitting muscle weakness present for more than 2 months, symmetrical proximal and distal extremity weakness and hyporeflexia.[neuroweb.us]
Mononeuropathy
  • 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]
  • Most patients develop either relapsing/remitting multiple mononeuropathies or slowly progressive symmetrical sensory peripheral neuropathy resembling syringomyelia. NCVs are slowed.[neuroweb.us]

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

  • 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 prognosis for Leigh syndrome is poor. Depending on the defect, individuals typically live a few years.[rarediseasesnetwork.org]
  • Three mutations at basepairs 11778, 3460, and 14484 in 90% Mid-life acute or subacute central vision loss ( central scotoma progressing to blindness The 14484 mutation has a good visual prognosis Chronic progressive external opthalmoplegia (CPEO) A spectrum[ganfyd.org]
  • 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]
  • They are organised into groups, and further divided into clinical, etiological or histopathological sub-types.[orpha.net]
  • 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.[rarediseases.info.nih.gov]
  • 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]
  • 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. [7] Epidemiology Frequency Worldwide Worldwide, the prevalence of mitochondrial disease[emedicine.medscape.com]
  • 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]
Sex distribution
Age distribution

Pathophysiology

  • Minagar has significant interest in pathophysiology and neuroimaging features of the inflammatory disease of human central nervous system, in general, and multiple sclerosis, in particular.[books.google.com]
  • Pathophysiology Mitochondrial DNA encodes for essential components of the respiratory chain. Deletions of various lengths of mtDNA results in defective mitochondrial function, particularly in highly oxidative tissues (eg, muscle, brain, heart).[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]
  • Hypertrophy of the brea … Carnitine Palmitoyltransferase I Deficiency Carnitine palmitoyltransferase I deficiency is a rare metabolic disorder that prevents the body from converting certain fats called long-chain fatty acids into energy, particularly[checkrare.com]
  • 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]

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