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X-Linked Spinocerebellar Ataxia Type 5

X-Linked Non-Progressive Cerebellar Ataxia


Presentation

  • Vertigo, dizziness, and imbalance rank amongst the most common presenting symptoms in neurology, ENT, geriatric medicine, and general practice.[books.google.com]
  • In a review of 109 cases of ALD, six cases presented after the age of 20 years, and four patients had psychiatric symptoms at the time of presentation. 12 Among 34 adult-onset ALD cases, 19 (56%) were reported to have psychiatric symptoms. 13 In 13 of[e-jmd.org]
  • Reduced diffusivity and abnormal MR spectroscopy peaks can also be present.[ajnr.org]
  • DISCUSSION In the present study we describe a family in which an early onset, non-progressive, mild form of cerebellar ataxia is associated with a reciprocal translocation t(8;20)(p22;q13).[jmg.bmj.com]
  • Many different types of inherited ataxias are presently known. Examples include Machado-Joseph disease, ataxia-telangiectasia, and Friedreich ataxia.[encyclopedia.com]
Disability
  • […] specialists involved in the management of the fetus and the neonate with the latest information on the developmental neurology and pathology of the developing central nervous system, so that they can provide prompt and informed treatment of neurological disability[books.google.com]
  • Ataxia as a result of trauma or infection may be a temporary condition, or leave some degree of permanent disability. Hereditary ataxias are usually progressive syndromes, with symptoms becoming more disabling over varying periods of time.[encyclopedia.com]
  • There is gradual progression of disability, with death occurring 10-30 years after onset [ 10 ]. Spinocerebellar ataxia type 2 (SCA2) SCA2 is due to a mutation on the number 12 chromosome and it is also known as Wadia-Swami syndrome [ 11 ].[patient.info]
  • Treatment and prognosis Edit There is no known cure for spinocerebellar ataxia, which is a progressive disease (it gets worse with time), although not all types cause equally severe disability.[psychology.wikia.com]
  • Other forms of ataxias can present with additional neurological symptoms, including tremor, epilepsy, spasticity, dementia, and/or neuropathy, and some patients demonstrate deafness and intellectual disability.[centogene.com]
Physician
  • It serves a useful clinical reference for neurologists, otorhinolaryngologists, audio-vestibular physicians, and senior trainees in those specialties.[books.google.com]
  • All reviewed studies had either a minimum two-physician assessment or used a standardized rating scale to assess ataxia. All journal articles reviewed were written in English.[movementdisorders.org]
  • What every physician needs to know. Cerebellar degeneration refers to cerebellar cell loss or damage with resulting neurologic findings. It is a descriptive term rather than a diagnosis unto itself.[clinicaladvisor.com]
  • Neurologists and other physicians provide treatment for the resulting symptoms. Genetic counseling and risk assessment of individuals without symptoms, but with a family history of the disease, is the task of the geneticist.[encyclopedia.com]
  • Evaluation and Management of Ataxic Disorders: An Overview for Physicians. Minneapolis: National Ataxia Foundation. p. 6. ISBN 0-943218-14-4. LCCN 2007923539. Online Mendelian Inheritance in Man (OMIM) 609307 Jiang, Bingcheng; Glover, J.N.[en.wikipedia.org]
Developmental Delay
  • Symptoms The following features are generally typical, although there is some variation between diseases: Developmental delay. Episodes of altered level of consciousness or recurrent neurological symptoms.[patient.info]
  • delay, mental retardation, and seizures.[emedicine.medscape.com]
  • In more severe cases, usually associated with paternal inheritance of the defective gene, heart failure, liver disorders, muscle loss, and developmental delays can all occur.[encyclopedia.com]
  • Screening for OPHN1 mutations in a large cohort of boys with cognitive impairment and vermis hypoplasia led to identification of mutations of this gene in 12%. 42 Patients with Opitz/BBB syndrome are also characterized by developmental delay, ataxia,[ajnr.org]
  • Delay 2 Congenital Cystic Disease Of Liver 4 Congenital Disorder Of Glycosylation Type 1A 2 Congenital Disorder Of Glycosylation Type 1B 2 Congenital Disorder Of Glycosylation Type 1C 2 Congenital Disorder Of Glycosylation Type 1D 2 Congenital Disorder[preventiongenetics.com]
Asymptomatic
  • An asymptomatic brother and sister tested negative. This mutation has not previously been recognized as a disease-causing or benign variant.[neurology.org]
  • Although his mother (B-I-1) and one (B-II-1) of his elder sisters were later found to carry the heterozygous c.1866-10G A (p.P623fs) mutation, they had remained asymptomatic.[journals.plos.org]
  • This issue is especially relevant in studies based on genetic centre records, where clinical inclusion criteria are clearly needed to differentiate clinically affected patients from asymptomatic or presymptomatic carriers.[karger.com]
  • Cortical Function in Asymptomatic Carriers and Patients With C9orf72 Amyotrophic Lateral Sclerosis. JAMA Neurology, 72(11), 1268-1274.[sydney.edu.au]
Muscle Cramp
  • Muscle cramps, muscle weakness, easy fatigability. Myoglobinuria with strenuous exercise.[kumc.edu]
  • cramps 9.5 11 0 0 0 4.1 2.4 Fasciculations 11.9 37 15.7 9.5 6.8 13.8 9.7 Amyotrophy 0 2 84.9 0 0 0 0 Extrapyramidal Extrapyramidal 9.5 18 13.9 14.2 6.8 9.7 21.9 Pyramidal Hyperreflexia 33.3 16 68.4 23.8 24.1 36.1 21.9 Arreflexia 7.1 23 0 9.8 6.8 12.5[slideshare.net]
Leg Cramp
  • Over the next 15 years, he developed progressive cerebellar ataxia with bulbar dysfunction, forgetfulness, leg cramps with sensory-predominant neuropathy/ganglionopathy, and dysexecutive behavior with obsessional thinking.[neurology.org]
Benign Paroxysmal Positional Vertigo
  • Individual chapters address benign paroxysmal positional vertigo, vestibular migraine, vestibular neuritis, stroke, and Ménière's disease.[books.google.com]
Fear
  • […] the management of the fetus and the neonate with the latest information on the developmental neurology and pathology of the developing central nervous system, so that they can provide prompt and informed treatment of neurological disability - the most feared[books.google.com]
Aggressive Behavior
  • Clinical features Early onset tremor, ataxia in the second decade, and orofacial dyskinesias Aggressive behavioral outbursts Spinocerebellar ataxia 28 See the list below: Clinical features Age of onset - 6-60 years (mean 30.7 y) Slowly progressive Standing[emedicine.medscape.com]
Ataxia
  • The genetic cause is known only for early-onset ataxia with ATP2B3 mutations.[neurology.org]
  • Some of the specific types of genetic ataxia include: Ataxia telangiectasia Ataxia with oculomotor apraxia Dominant spastic ataxias Dominant spinocerebellar ataxias ( SCA ) Episodic ataxia Friedreich's ataxia Recessive spastic ataxias Wilson’s disease[webmd.com]
  • ataxias are labeled as “EA” SPAX refers to ataxia subtypes that have a prominent component of spasticity 1, 5.[centogene.com]
  • […] onset cerebellar ataxia Friedreich's ataxia Friedreichs ataxia Josephs disease Lumbar neuromuscular scoliosis due to friedreich's ataxia Lumbar scoliosis due to friedreichs ataxia Lumbosacral neuromuscular scoliosis due to friedreich's ataxia Lumbosacral[icd10data.com]
  • […] type (PRKC) Spinocerebellar ataxia (SCA15/SCA 16) OMIM #606658 Pure ataxia with slow progression Tremor Mutations or deletions on ITPR1 gene 3p26.1 Spinocerebellar ataxia (SCA17) OMIM #607136 Ataxia Pyramidal and extrapyramidal signs Dementia Widespread[emedicine.medscape.com]
Cerebellar Ataxia
  • Both cases featured congenital hypotonia, delayed motor development, and cerebellar ataxia. Imaging revealed isolated cerebellar atrophy or a small posterior fossa and a dysplastic corpus callosum.[neurology.org]
  • The following individuals are candidates for cerebellar ataxia panel testing: Individuals with a family history of cerebellar ataxia and presentation of the most common symptoms Individuals without a positive family history of cerebellar ataxia, but with[centogene.com]
  • Applicable To Early-onset cerebellar ataxia with essential tremor Early-onset cerebellar ataxia with myoclonus [Hunt's ataxia] Early-onset cerebellar ataxia with retained tendon reflexes Friedreich's ataxia (autosomal recessive) X-linked recessive spinocerebellar[icd10data.com]
  • ataxia LOCA: Late onset sporadic cerebellar ataxia 84.[slideshare.net]
  • An extended phenotype of an early-onset inherited nonprogressive cerebellar ataxia syndrome. J Child Neurol 1991 ; 6 : 20 –3. Imamura S , Tachi N, Oya K. Dominantly inherited early-onset non-progressive cerebellar ataxia syndrome.[jmg.bmj.com]
Vertigo
  • Vertigo, dizziness, and imbalance rank amongst the most common presenting symptoms in neurology, ENT, geriatric medicine, and general practice.[books.google.com]
  • The crisis starts with vertigo and ataxia, and is often associated with involuntary eye movements. This condition is treatable with daily administration of acetozolamide.[encyclopedia.com]
  • When the nerves in your vestibular system wear away, you can have the following problems: Blurred vision and other eye issues Nausea and vomiting Problems standing and sitting Staggering when you walk Trouble walking in a straight line Vertigo, or dizziness[webmd.com]
  • Cerebellar exam findings, such as ataxia, vertigo, and dysmetria, are associated with other forms of cerebellar insult besides inherited disorders.[clinicaladvisor.com]
  • Vestibular dysfunction  Vertigo is prominent  Consistent fall to one side  Nystagmus  Limb ataxia is absent  Speech is normal  Joint position sense is normal Patient complains of vertigo rather than imbalance 9.[slideshare.net]
Encephalopathy
  • Such conditions may be encountered both as part of ‘static’ congenital encephalopathies as well as in the frame of neurodegenerative or neurometabolic disorders.[books.google.com]
  • Encephalopathy, Early Infantile, 19 1 Epileptic Encephalopathy, Early Infantile, 2 7 Epileptic Encephalopathy, Early Infantile, 21 1 Epileptic Encephalopathy, Early Infantile, 23 1 Epileptic Encephalopathy, Early Infantile, 24 5 Epileptic Encephalopathy[preventiongenetics.com]
  • […] dominant, 3 AR 37 80 C5ORF42 Orofaciodigital syndrome, Joubert syndrome AR 97 103 CA8 Cerebellar ataxia, mental retardation, and dysequilibrium syndrome AR 4 4 CACNA1A Migraine, familial hemiplegic, Episodic ataxia, Spinocerebellar ataxia 6, Epileptic encephalopathy[blueprintgenetics.com]
  • Hashimoto’ Encephalopathy: Systematic Review of the Literature (The Journal of Neuropsychiatry and Clinical Neurosciences 2011; 23:384 –390) 62.[slideshare.net]
  • Miller Fisher variant of Guillain-Barre syndrome, glutamic acid decarboxylase (ADA) antibody-associated ataxia (a sporadic ataxia seen in women, often with type 1 diabetes or other autoimmune conditions), celiac disease and gluten ataxia, and Hashimoto’s encephalopathy[clinicaladvisor.com]
Stroke
  • Individual chapters address benign paroxysmal positional vertigo, vestibular migraine, vestibular neuritis, stroke, and Ménière's disease.[books.google.com]
  • Collaborative Meta-Analysis of Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke in High Risk Patients. ‎[books.google.es]
  • Causes and symptoms Ataxia may be a consequence of brain trauma, stroke, or aneurysm.[encyclopedia.com]
  • CAC can be caused by acquired or inherited diseases, including brain injury (stroke, trauma, hypoxia-ischemia), malformation (Joubert syndrome and associated disorders, cerebellar dysgenesis, rhombencephalosyanapsis), hereditary degenerative disorders[ajnr.org]
  • These other triggers include: Vascular disorders, such as embolic or thrombotic stroke, dissection, vasculitis, or haemorrhage Medications, such as anti-epileptic drugs (especially phenytoin, which can cause both an acute ataxia as well as a chronic cerebellar[clinicaladvisor.com]

Workup

MRI Shows Cerebellar Atrophy
  • Clinical features Late-onset ataxia Slowly progressive Lower limb more affected than upper limb Dysarthria, ocular dysmetria Spasmodic torticollis in some Brain MRI shows cerebellar atrophy in some No anticipation Cognitive deterioration, epilepsy, signs[emedicine.medscape.com]

Treatment

  • Focused on treatment: key points boxes pick out the most important information for the busy specialist. Evidence-based information: extensively referenced with the latest and most important papers and articles.[books.google.com]
  • To identify relevant publications, a PubMed search using the terms “treatments of cerebellar ataxias,” “degenerative cerebellar ataxia treatment,” and “treatment of hereditary cerebellar ataxia” was conducted.[movementdisorders.org]
  • Food and Drug Administration has chosen Wave Life Sciences’ planned phase 2/3 study of suvodirsen, its lead experimental therapy for the treatment of Duchenne muscular dystrophy, to break new ground.[globalgenes.org]
  • (a cancer either recurs after treatment eliminates it, or it doesn't).[healthbreakingnews.net]
  • Treatment team Neurologists and geneticists are the front line treatment team for people with ataxia, along with specialized nurses and therapists.[encyclopedia.com]

Prognosis

  • Prognosis Prognosis is highly variable between the different types but improvement is unlikely.[patient.info]
  • Most acute ataxias are ingestions and postviral and have a good prognosis. If recovery from a presumed postviral ataxia is delayed ( 2 weeks), evaluation for neuroblastoma sho... Blaser SI, Steinlin M, Al-Maawali A, et al.[5minuteconsult.com]
  • These evaluations may demonstrate that the patient requires rehabilitation following discharge, and, depending upon the prognosis, even long-term placement in a skilled nursing facility. F. Prognosis and Patient Counseling.[clinicaladvisor.com]
  • 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]
  • The descriptions of the clinical conditions each systematically cover, as appropriate, epidemiology, prevalence, diagnostic criteria, clinical features (including course and prognosis), pathophysiology, genetics, investigations, differential diagnosis[deutscher-apotheker-verlag.de]

Etiology

  • CCA was defined as an SCA of unknown etiology with imaging evidence of isolated cerebellar atrophy.[movementdisorders.org]
  • Imaging is not necessary to confirm the diagnosis but can help confirm cerebellar atrophy and rule out other etiologies of cerebellar disease.[clinicaladvisor.com]
  • This study expands the mutational spectrum of AVALD and underscores the importance of considering ALD as a potential etiology of cerebellar ataxia.[journals.plos.org]
  • Etiology- IgA/IgG Anti-Gliadin Ab, Anti-endomysial Ab and Ab against Tissue Trans-glutaminase Rx-Gluten free diet, I.V.[slideshare.net]
  • Moreover, increased intracellular Ca 2 , which promotes transglutaminase activation, is of vital importance in the etiology of neurologic diseases.[emedicine.medscape.com]

Epidemiology

  • Consequently, they are often approached together in epidemiological studies.[karger.com]
  • Relevant External Links for ATP2B3 Genetic Association Database (GAD) ATP2B3 Human Genome Epidemiology (HuGE) Navigator ATP2B3 Atlas of Genetics and Cytogenetics in Oncology and Haematology: ATP2B3 No data available for Genatlas for ATP2B3 Gene Mutation[genecards.org]
  • Epidemiology Prevalence of ADCAs has been estimated as between 0.3 to 2 per 100,000 [ 7 ].[patient.info]
  • The descriptions of the clinical conditions each systematically cover, as appropriate, epidemiology, prevalence, diagnostic criteria, clinical features (including course and prognosis), pathophysiology, genetics, investigations, differential diagnosis[deutscher-apotheker-verlag.de]
  • 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

  • The descriptions of the clinical conditions each systematically cover, as appropriate, epidemiology, prevalence, diagnostic criteria, clinical features (including course and prognosis), pathophysiology, genetics, investigations, differential diagnosis[deutscher-apotheker-verlag.de]
  • […] and body sway during the 2-week titration period as well as the 8-week reassessment. [31] Insulin-Like Growth Factor Insulin-like growth factor-1 (IGF-1) acts as a neuromodulator in the CNS. [32] Disturbances in CNS signaling pathways may produce the pathophysiological[movementdisorders.org]
  • "Cerebellar ataxia: Pathophysiology and rehabilitation". Clinical Rehabilitation. 25 (3): 195–216. doi : 10.1177/0269215510382495. PMID 21321055. "SCA2 information sheet from www.ataxia.org" (PDF). Archived from the original (PDF) on 2012-07-12.[en.wikipedia.org]
  • Central ataxia, Lower limb tremor, Psychosis, Dementia Damage to GABA-A receptor, Impaired Glucose metabolism,VitB1 deficiency MRI-Superior cerebellar and cerebral atrophy Alcohol abstinence,VitB1 replacement Pathophysiology MRI Treatment Toxins- Alcoholic[slideshare.net]
  • Pathophysiological insights into ALS with C9ORF72 expansions. Journal of Neurology, Neurosurgery and Psychiatry, 84(8), 931-935.[sydney.edu.au]

Prevention

  • Collaborative Meta-Analysis of Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke in High Risk Patients. ‎[books.google.es]
  • 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]
  • Appropriate Prophylaxis and Other Measures to Prevent Readmission. Careful consideration of functional status and needs upon discharge are important.[clinicaladvisor.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]
  • Advances in genetic research in the last decades have improved their diagnosis and brought new possibilities for prevention and future treatments. Still, there is great uncertainty regarding their global epidemiology.[karger.com]

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