Tallaksen Chantal M E
Nevrologisk avdeling, Ullevål universitetssykehus, 0407 Oslo.
Tidsskr Nor Laegeforen. 2008 Sep 11;128(17):1977-80.
Hereditary ataxias constitute a heterogeneous group of rare neurodegenerative diseases with an increasingly unsteady gait as the most common symptom. The three main groups: hereditary, sporadic and acquired ataxias, are difficult to distinguish from one another clinically. This overview will focus mainly on hereditary ataxias.
The article is based on own research, clinical experience and literature retrieved from searches in the MedLine and Cochrane databases.
Autosomal dominant cerebellar ataxias constitute the largest group and includes spinocerebellar ataxias (SCA 1-29), dentatorubral-pallidolyisian atrophy (DRPLA) and episodic ataxias (EA 1-6). Diagnosis is based on family history, clinical findings and can be confirmed with molecular tests for 50-60% of cases. Autosomal recessive ataxias usually start in childhood and consist of a group of heterogenous conditions of which Friedreich's ataxia and ataxia teleangiectasia are the most frequent types. Several metabolic and mitochondrial diseases are included in the group, but are not covered by this review. Curative treatment is usually not available for these diseases, but use of appropriate symptomatic drugs and physiotherapy may contribute to substantial improvement of the patient's symptoms and prognosis.
These conditions are rare, the prevalence is about 6/100,000 and they represent a diagnostic challenge. There is much ongoing research in the field with new possibilities for diagnosis and treatment. (For that reason it is important to be able to identify relevant patients and inform them properly) It is therefore important to identify the patients and give them the relevant information.
遗传性共济失调是一组异质性罕见神经退行性疾病,步态不稳日益加重是其最常见症状。遗传性、散发性和获得性共济失调这三大类在临床上难以相互区分。本综述主要聚焦于遗传性共济失调。
本文基于自身研究、临床经验以及从MedLine和Cochrane数据库检索到的文献。
常染色体显性遗传性小脑共济失调是最大的一组,包括脊髓小脑共济失调(SCA 1 - 29)、齿状核红核苍白球路易体萎缩(DRPLA)和发作性共济失调(EA 1 - 6)。诊断基于家族史、临床发现,50% - 60%的病例可通过分子检测确诊。常染色体隐性遗传性共济失调通常始于儿童期,由一组异质性疾病组成,其中弗里德赖希共济失调和共济失调毛细血管扩张症是最常见的类型。该组还包括几种代谢性和线粒体疾病,但本综述未涵盖。这些疾病通常没有治愈性治疗方法,但使用适当的对症药物和物理治疗可能有助于显著改善患者症状和预后。
这些疾病较为罕见,患病率约为6/100,000,且诊断具有挑战性。该领域有许多正在进行的研究,为诊断和治疗带来了新的可能性。(因此,能够识别相关患者并为他们提供适当信息非常重要)所以识别患者并给予他们相关信息很重要。