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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]
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]
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]
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 Weakness in muscles of upper arms and upper legs 0003701 Ptosis Drooping upper eyelid 0000508 Ragged-red muscle fibers 0003200[rarediseases.info.nih.gov]
  • romberg sign 64 65.[slideshare.net]
  • Romberg sign Abnormality of the cerebral white matter Progressive proximal muscle weakness Ophthalmoparesis Headache Encephalopathy EMG: myopathic abnormalities Limb ataxia Dilated cardiomyopathy Facial palsy Tics Frontal bossing Sensory ataxic neuropathy[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 36 5%-29% of people have these symptoms Cataract Clouding of the lens of the eye Cloudy lens [ more ] 0000518 Percent of people who have these symptoms is not available through HPO Adult onset Symptoms begin in adulthood 0003581 Areflexia Absent[rarediseases.info.nih.gov]
  • […] failure Decreased nerve conduction velocity Rhabdomyolysis Motor delay Milia X-linked recessive inheritance Reduced visual acuity Pallor Babinski sign Congenital nystagmus Cerebral atrophy Hypoplasia of the corpus callosum Hyperreflexia Kinetic tremor 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
  • […] serum creatine kinase Increased CPK Increased creatine kinase Increased creatine phosphokinase Increased serum CK Increased serum creatine kinase Increased serum creatine phosphokinase [ more ] 0003236 Gastroparesis Delayed gastric emptying 0002578 Hyporeflexia[rarediseases.info.nih.gov]
  • 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]
  • […] cavus Dysarthria Tremor Gait disturbance Cardiomyopathy Scoliosis Nystagmus Proximal muscle weakness Dysphagia Optic atrophy Cognitive impairment Cerebellar atrophy Seizures Autosomal dominant inheritance Lower limb muscle weakness Limb muscle weakness Hyporeflexia[mendelian.co]
  • 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]

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]
  • 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]

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]
  • Stroke in adults, etiologies 72. Stroke in the young, etiologies 73. Syncope 74. Tinnitus 75. Tremor 76. Vertigo 77. Visual loss, acute bilateral 78. Visual loss, monocular 79. Visual field deficits 80. Weakness, generalized acute 81.[euro-libris.ro]

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 Global Epidemiology of Hereditary Ataxiaand Spastic Paraplegia: A systematic review of prevalence studies. Neuroepidemiology 2014; 24:174-183. Ashizawa T, Figueroa KP, Perlman SL, et al.[rarediseases.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 (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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