Fazeli Walid, Becker Kerstin, Herkenrath Peter, Düchting Christoph, Körber Friederike, Landgraf Pablo, Nürnberg Peter, Altmüller Janine, Thiele Holger, Koy Anne, Liebau Max C, Simon Thorsten, Dötsch Jörg, Cirak Sebahattin
Division of Pediatric Neurology, Department of Pediatrics, University Hospital Cologne, Cologne, Germany.
Institute for Molecular and Behavioral Neuroscience, University of Cologne, Cologne, Germany.
Neuropediatrics. 2018 Dec;49(6):379-384. doi: 10.1055/s-0038-1668141. Epub 2018 Aug 30.
Mutations in are associated with a heterogeneous clinical spectrum including epilepsy and autism. Here, we have identified a peculiar phenotype associated with vaccination related exacerbations of ataxia. We report the first family with three individuals affected by -associated episodic ataxia (EA) with impaired speech development. The index patient manifested his first episode of subacute cerebellar ataxia at the age of 12 months, 3 weeks after vaccinations for measles, mumps, rubella, and varicella. Cranial magnetic resonance imaging showed a lesion of the left cerebellar hemisphere, which was first considered as a potential cause of the ataxia. The patient fully recovered within 3 weeks, but developed three very similar episodes of transient ataxia within the following 24 months. Whole exome sequencing of the index patient revealed a heterozygous autosomal-dominant mutation in (NM_021007, c.4949T > C; p.L1650P), which was confirmed in the likewise affected mother, and was then also identified in the younger brother who developed the first episode of ataxia. We hereby extend the recently described spectrum of -associated neurologic disorders, emphasizing that mutations should also be considered in familial cases of EA. Coincidental imaging findings or other associated events such as immunizations should not protract genetic investigations.
[基因名称]的突变与包括癫痫和自闭症在内的多种临床症状相关。在此,我们发现了一种与疫苗接种相关的共济失调加重有关的特殊表型。我们报告了首例有三名个体受[基因名称]相关发作性共济失调(EA)影响且伴有言语发育受损的家庭。索引患者在12个月大时,即在接种麻疹、腮腺炎、风疹和水痘疫苗3周后,首次出现亚急性小脑共济失调发作。头颅磁共振成像显示左侧小脑半球有病变,该病变最初被认为是共济失调的潜在病因。患者在3周内完全康复,但在接下来的24个月内又出现了三次非常相似的短暂性共济失调发作。对索引患者进行的全外显子组测序揭示了[基因名称](NM_021007,c.4949T>C;p.L1650P)中的一个杂合常染色体显性突变,在同样患病的母亲中得到证实,随后在出现首次共济失调发作的弟弟中也被发现。我们在此扩展了最近描述的[基因名称]相关神经系统疾病的范围,强调在EA的家族病例中也应考虑[基因名称]突变。巧合的影像学发现或其他相关事件(如免疫接种)不应拖延基因调查。