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Spinocerebellar Ataxia Type 4

SCA4


Presentation

  • Clinical description SCA4 typically starts in middle-aged adults and presents with cerebellar ataxia, pyramidal signs, and peripheral sensory loss.[orpha.net]
  • In the present study, the first available cerebellar and brainstem tissue of a clinically diagnosed and genetically-confirmed German SCA4 patient was pathoanatomically studied using serial thick sections.[ncbi.nlm.nih.gov]
  • As the disease progresses, abnormal movements become more pronounced and can present problems in gait, speech or swallowing. Survival from the onset of symptoms, may be a few years to over a decade.[ivami.com]
  • Macular drusen were present bilaterally (Fig. 3), and retinal autofluorescence was suggestive of central atrophy. The optic discs were normal.[journals.lww.com]
  • R....Bhomaj S. 2016 3 Meningoencephalitis, myositis, and rash-neurological presentation of Indian tick typhus. ( 27365979 ) Nigam G....Sobhana C. 2016 4 Indian tick typhus presenting with gangrene: a case report from an urban slum of delhi. ( 23783766[malacards.org]
Progressive Dementia
  • Other X-ADL symptoms are seizures, speech and swallowing difficulties, gait and coordination ataxia, visual loss, progressive dementia, and loss of hearing that ends in deafness.[encyclopedia.com]
Retinal Pigmentation
  • Focal thickening of the retinal pigment epithelium complex was present in the right eye (Fig. 4). Measurement of macular and global RNFL thickness was normal (Table 2).[journals.lww.com]
Long Arm
  • In spinocerebellar ataxia type 17 (HDL4) it is affected TBP gene, located on the long arm of chromosome 6 (6q27). The TBP gene encoding the binding protein TATA, important for the development of normal brain function box.[ivami.com]
Anger
  • , Angers, France; Department of Ophthalmology (DM), Copenhagen University Hospital, Copenhagen, Denmark; and Singapore National Eye Centre and Singapore Eye Research Institute (DM), Singapore.[journals.lww.com]
Cerebellar Ataxia
  • The clinical phenotype is characterized by cerebellar ataxia with sensory neuropathy. We describe a five-generation family from northern Germany with similar clinical findings linked to the same locus.[ncbi.nlm.nih.gov]
  • Clinical description SCA4 typically starts in middle-aged adults and presents with cerebellar ataxia, pyramidal signs, and peripheral sensory loss.[orpha.net]
  • Overview When people discuss spinal cerebellar ataxia (SCA), they are actually referring to a group of neurodegenerative disorders that cause progressive clumsiness.[verywell.com]
  • Autosomal dominant cerebellar ataxias. Rev Neurol (Paris). 2011;167:385–400. 16. Gouw LG, Digre KB, Harris CP, Haines JH, Ptacek LJ.[journals.lww.com]
Hyporeflexia
  • Current clinical features Cerebellar features Cerebellar dysarthria, limb and truncal ataxia, slow saccades, wheelchair bound Cerebellar dysarthria, limb and truncal ataxia Saccadic speech, dysphagia, slow saccades, limb and truncal ataxia, titubation, hyporeflexia[movementdisorders.org]
  • Examination of lower and upper limb for reflex can also help to diagnosis because people will development areflexia or hyporeflexia in their limbs[3].[neurowiki2013.wikidot.com]
Areflexia
  • Examination of lower and upper limb for reflex can also help to diagnosis because people will development areflexia or hyporeflexia in their limbs[3].[neurowiki2013.wikidot.com]
Irritability
  • Early symptoms include irritability, emotional problems, involuntary movements, poor motor coordination and learning or decision - making.[ivami.com]

Workup

  • In selected patients with lower cranial dystonia, especially jaw and tongue dystonia, SCA2 might be considered during the diagnostic workup.[movementdisorders.org]

Treatment

  • 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]
  • […] of Spinocerebellar Ataxia Medical research yet now unable to discover the curative treatment for spinocerebellar ataxia, even the available treatment is not able to control the disease progression.[healthsaline.com]
  • ., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment.[medicalmarijuanainc.com]
  • Business Media , 11 mar. 2010 - 304 páginas This reference on the state-of-the-art of neuromuscular diseases as a whole offers a current review of inherited neuromuscular diseases under different approaches: genetics, pathomechanisms, therapies and treatments[books.google.es]
  • Treatment There is no cure for SCA. Medications such as zolpidem or varenicline have been suggested to help ataxia in SCA type 2 and 3 respectively. Types SCA1 SCA1 causes about 3 to 16 percent of autosomal dominant cerebellar ataxias.[verywell.com]

Prognosis

  • Prognosis There is insufficient clinical data to draw conclusions concerning prognosis.[orpha.net]
  • Prognosis Spinocerebellar ataxias due to repeat expansion mutations usually become sick in middle age. In addition to ataxia, other neurological findings are often present depending on the variant of SCA.[verywell.com]
  • Prognosis Prognosis is highly variable between the different types but improvement is unlikely.[patient.info]
  • The prognosis is bleak, with a gradual progression to disability and death within 10-20 years. Ref: Orr, H.T. et al. (1993). Expansion of an unstable CAG trinucleotide repeat in spinocerebellar ataxia type I. Nature Genet. 4, 221-26.[gpnotebook.co.uk]
  • Prognosis The prognosis for a person with ataxia depends upon the type and nature of the disease. Ataxia as a result of trauma or infection may be a temporary condition, or leave some degree of permanent disability.[encyclopedia.com]

Etiology

  • Etiology The disease has been linked to chromosome 16q22.1 in kindreds from Utah (USA) and Germany but the mutation is yet unknown and does not appear to involve trinucleotide repeats.[orpha.net]

Epidemiology

  • Summary Epidemiology Prevalence is unknown. Clinical description SCA4 typically starts in middle-aged adults and presents with cerebellar ataxia, pyramidal signs, and peripheral sensory loss.[orpha.net]
  • Epidemiology Prevalence of ADCAs has been estimated as between 0.3 to 2 per 100,000 [ 7 ].[patient.info]
  • Molecular epidemiology of spinocerebellar ataxias in Cuba: insights into SCA2 founder effect in Holguin. Neurosci Lett. 2009 Apr 24;454(2):157-60. doi: 10.1016/j.neulet.2009.03.015. Epub 2009 Mar 11.[ghr.nlm.nih.gov]
  • Sequeiros J: Machado- Joseph disease: epidemiology, genetics and genetic epidemiology; in Lechtenberg R (ed): Handbook of Cerebellar Diseases, Dekker, NY, 1993, pp. 345- 351. Nance MA, Myers RH.[bvs.sld.cu]
  • 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

  • Anatomically based guidelines for systematic investigation of the central somatosensory system and their application to a spinocerebellar ataxia type 2 (SCA2) patient Neuropathol Appl Neurobiol 29 418 433 CrossRef Google Scholar Said, G, Thomas, PK 1992 Pathophysiology[link.springer.com]

Prevention

  • Involved in degradation of misfolded chaperone substrates via its interaction with STUB1/CHIP- recruited to monoubiquitinated STUB1/CHIP, and restricts the length of ubiquitin chain attached to STUB1/CHIP substrates and preventing further chain extension[string-db.org]
  • Protein coding - E0CYM2 - 3' truncation in transcript evidence prevents annotation of the end of the CDS. CDS 3' incomplete Transcript Support Level 5, for transcripts that are not supported at all by either an mRNA or an EST.[ensembl.org]
  • Prevention Genetic testing enables identification of the causative gene in 50-80% of cases of ADCA [ 15 ]. Pre-symptomatic testing is available but not always wanted. It is usually requested for family planning purposes.[patient.info]
  • A major cannabinoid found in cannabis, tetrahydrocannabinol (THC), has been shown to help in the treatment of Parkinson’s disease by preventing free radical damage and encouraging the formation of new mitochondria (Zeissler, et al., 2013).[medicalmarijuanainc.com]
  • Treatment Except for some acquired and reversible forms of ataxia as initially described, there is no cure or preventive treatment for the progressive forms of the disease, or for those ataxias resulting from accidental lesions of motor brain areas and[encyclopedia.com]

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