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婴儿神经轴索性营养不良与PLA2G6相关神经变性:诊断进展

Infantile neuroaxonal dystrophy and PLA2G6-associated neurodegeneration: An update for the diagnosis.

作者信息

Iodice Alessandro, Spagnoli Carlotta, Salerno Grazia Gabriella, Frattini Daniele, Bertani Gianna, Bergonzini Patrizia, Pisani Francesco, Fusco Carlo

机构信息

Child Neurology Unit, Arcispedale Santa Maria Nuova Hospital - IRCCS, Reggio Emilia, Italy.

Child Neurology Unit, Arcispedale Santa Maria Nuova Hospital - IRCCS, Reggio Emilia, Italy.

出版信息

Brain Dev. 2017 Feb;39(2):93-100. doi: 10.1016/j.braindev.2016.08.012. Epub 2016 Nov 21.

Abstract

Infantile neuroaxonal dystrophy is a rare neurodegenerative disorder characterized by infantile onset of rapid motor and cognitive regression and hypotonia evolving into spasticity. Recessively inherited mutations of the PLA2G6 gene are causative of infantile neuroaxonal dystrophy and other PLA2G6-associated neurodegeneration, which includes conditions known as atypical neuroaxonal dystrophy, Karak syndrome and early-onset dystonia-parkinsonism with cognitive impairment. Phenotypic spectrum continues to evolve and genotype-phenotype correlations are currently limited. Due to the overlapping phenotypes and heterogeneity of clinical findings characterization of the syndrome is not always achievable. We reviewed the most recent clinical and neuroradiological information in the way to make easier differential diagnosis with other degenerative disorders in the paediatric age. Recognizing subtle signs and symptoms is a fascinating challenge to drive towards better diagnostic and genetic investigations.

摘要

婴儿神经轴索性营养不良是一种罕见的神经退行性疾病,其特征为婴儿期起病,出现快速的运动和认知功能衰退,肌张力减退逐渐发展为痉挛。PLA2G6基因的隐性遗传突变是婴儿神经轴索性营养不良及其他PLA2G6相关神经退行性疾病的病因,后者包括非典型神经轴索性营养不良、卡拉克综合征以及伴有认知障碍的早发性肌张力障碍-帕金森综合征等疾病。其表型谱仍在不断演变,目前基因型与表型的相关性有限。由于临床表现存在重叠且具有异质性,该综合征的特征并不总是能够明确。我们回顾了最新的临床和神经放射学信息,以便更轻松地与儿科其他退行性疾病进行鉴别诊断。识别细微的体征和症状对于推动更好的诊断和基因研究而言是一项极具吸引力的挑战。

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