Graciani Zodja, Santos Silvana, Macedo-Souza Lucia Inês, Monteiro Carlos Bandeira de Mello, Veras Maria Isabel, Amorim Simone, Zatz Mayana, Kok Fernando
Department of Neurology, University of São Paulo School of Medicine, São Paulo, SP, Brazil.
Arq Neuropsiquiatr. 2010 Feb;68(1):3-6. doi: 10.1590/s0004-282x2010000100002.
Spastic paraplegia, optic atrophy, and neuropathy (SPOAN) is an autosomal recessive complicated form of hereditary spastic paraplegia, which is clinically defined by congenital optic atrophy, infancy-onset progressive spastic paraplegia and peripheral neuropathy. In this study, which included 61 individuals (age 5-72 years, 42 females) affected by SPOAN, a comprehensive motor and functional evaluation was performed, using modified Barthel index, modified Ashworth scale, hand grip strength measured with a hydraulic dynamometer and two hereditary spastic paraplegia scales. Modified Barthel index, which evaluate several functional aspects, was more sensitive to disclose disease progression than the spastic paraplegia scales. Spasticity showed a bimodal distribution, with both grades 1 (minimum) and 4 (maximum). Hand grip strength showed a moderate inverse correlation with age. Combination of early onset spastic paraplegia and progressive polyneuropathy make SPOAN disability overwhelming.
痉挛性截瘫、视神经萎缩和神经病变(SPOAN)是遗传性痉挛性截瘫的一种常染色体隐性复杂形式,临床特征为先天性视神经萎缩、婴儿期起病的进行性痉挛性截瘫和周围神经病变。在这项研究中,纳入了61例受SPOAN影响的个体(年龄5 - 72岁,42例女性),使用改良巴氏指数、改良Ashworth量表、用液压测力计测量的握力以及两种遗传性痉挛性截瘫量表进行了全面的运动和功能评估。评估多个功能方面的改良巴氏指数比痉挛性截瘫量表对揭示疾病进展更敏感。痉挛表现为双峰分布,既有1级(最小)也有4级(最大)。握力与年龄呈中度负相关。早发性痉挛性截瘫和进行性多发性神经病变的结合使SPOAN导致的残疾极为严重。