Chen Zhongbo, Puzriakova Arina, Houlden Henry
Department of Neurodegenerative Disease UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery London, United Kingdom
Department of Neuromuscular Disease UCL Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery London, United Kingdom
Spinocerebellar ataxia type 11 (SCA11) is characterized by progressive cerebellar ataxia and abnormal eye signs (jerky pursuit, horizontal and vertical nystagmus). Pyramidal features are seen on occasion. Peripheral neuropathy and dystonia are rare. Six families have been reported to date, one each from the UK, Pakistan, France, Germany, Denmark, and China. Age of onset ranged from early childhood to the mid-40s. Life span is thought to be normal.
DIAGNOSIS/TESTING: The diagnosis of spinocerebellar ataxia type 11 (SCA11) is established in a proband with a heterozygous pathogenic variant in identified by molecular genetic testing.
Management is supportive; there are no known disease-modifying treatments to date. Physiotherapy and assessment for assistive devices for ambulation; occupational therapy, including home adaptations; speech and language therapy for dysarthria and dysphagia; ankle-foot orthotics if required and good foot care for those with neuropathy; treatment per ophthalmologist for vision issues; prism glasses may be helpful for diplopia. Annual neurologic evaluation; evaluations with physiotherapist, occupational therapist, speech and language therapist, and ophthalmologist as indicated.
SCA11 is inherited in an autosomal dominant manner. The proportion of SCA11 caused by mutation is unknown. Each child of an individual with SCA11 has a 50% chance of inheriting the pathogenic variant. Prenatal testing for an at-risk pregnancy is possible if the diagnosis has been established by molecular genetic testing in an affected family member.
11型脊髓小脑共济失调(SCA11)的特点是进行性小脑共济失调和异常眼征(急动性追踪、水平和垂直眼球震颤)。偶尔可见锥体束征。周围神经病变和肌张力障碍罕见。迄今为止已报道了6个家系,分别来自英国、巴基斯坦、法国、德国、丹麦和中国。发病年龄从幼儿期到40多岁不等。寿命被认为正常。
诊断/检测:通过分子遗传学检测在先证者中鉴定出杂合致病变异,从而确立11型脊髓小脑共济失调(SCA11)的诊断。
管理以支持性为主;迄今为止尚无已知的疾病改善治疗方法。进行物理治疗并评估步行辅助设备;职业治疗,包括家庭环境改造;针对构音障碍和吞咽困难的言语和语言治疗;如有需要,使用踝足矫形器,对有神经病变者进行良好的足部护理;由眼科医生针对视力问题进行治疗;棱镜眼镜可能有助于治疗复视。每年进行神经系统评估;根据需要由物理治疗师、职业治疗师、言语和语言治疗师以及眼科医生进行评估。
SCA11以常染色体显性方式遗传。由[具体基因名称]突变引起的SCA11比例未知。SCA11患者的每个孩子都有50%的机会继承致病变异。如果已通过对受影响家庭成员的分子遗传学检测确立诊断,则对高危妊娠进行产前检测是可行的。