Rosser Tena, Muir Jason, Panigrahy Ashok, Baldwin Erin E, Boles Richard G
Division of Neurology, Childrens Hospital Los Angeles, and Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles, California 90027, USA.
J Child Neurol. 2010 Aug;25(8):1013-6. doi: 10.1177/0883073809352378. Epub 2010 May 14.
X-linked hereditary demyelinating neuropathy (Charcot-Marie-Tooth 1X) accounts for 10% to 20% of all hereditary demyelinating neuropathies and is caused by mutations in the GJB1 gene, which codes for connexin 32. Connexin 32 is a gap junction protein widely expressed in Schwann cells as well as oligodendrocytes. Transient leukoencephalopathy has been reported in children and adults with Charcot-Marie-Tooth 1X. The case of a previously healthy 10-year-old boy who presented with fluctuating neurological deficits is reviewed. His brain magnetic resonance imaging scans showed abnormal restricted diffusion and mild hyperintense T2-weighted and fluid attenuation inversion recovery abnormalities in the splenium of the corpus callosum and the posterior cerebral white matter in a bilaterally symmetric distribution. A family history of Charcot-Marie-Tooth disease was revealed late in his presentation, and genetic testing identified a mutation in the GJB1 gene that has not previously been associated with central nervous system involvement.
X连锁遗传性脱髓鞘性神经病(夏科-马里-图斯病1X型)占所有遗传性脱髓鞘性神经病的10%至20%,由编码连接蛋白32的GJB1基因突变引起。连接蛋白32是一种缝隙连接蛋白,在施万细胞和少突胶质细胞中广泛表达。已有报道称,患有夏科-马里-图斯病1X型的儿童和成人会出现短暂性白质脑病。本文回顾了一名既往健康的10岁男孩的病例,该男孩出现了波动性神经功能缺损。他的脑部磁共振成像扫描显示,胼胝体压部和双侧大脑后白质出现异常的扩散受限,以及轻度T2加权高信号和液体衰减反转恢复异常,呈双侧对称分布。在他就诊后期发现了夏科-马里-图斯病家族史,基因检测确定了GJB1基因中的一个突变,该突变此前未与中枢神经系统受累相关。