Refsum S
Psychiatr Neurol Med Psychol Beih. 1977;22-23:11-8.
Heredopathia atactica polyneuritiformis is a clinical-genetic-biochemical entity. It is therefore not a syndrome, but a nosological entity, a morbus sui generis and it is caused by a single autosomal gene. The importance of phytanic acid accumulation in this disease was first demonstrated by Klenk and Kahlke. To the author's knowledge no case with all the typical symptoms and signs of heredopathia atactica polyneuritiformis and without any atypical clinical features, has yet been reported without a concomitant disturbance of phytanic acid metabolism. The dietary treatment--(a low phytol, low phytanic acid diet)--was first proposed by Eldjarn, when the preliminary experimental results indicated that the phytanic acid was of exogenous origin. Whatever the biochemical mechanism is between accumulation of phytanic acid and clinical manifestations in heredopathia atactica polyneuritiformis, it appears that the observations made on patients following successful dietary treatment are convincing and leave little doubt that most, if not all, the manifestations in this disease are caused in some way by the accumulation of phytanic acid.
多神经炎型共济失调性遗传病是一种临床-遗传-生化实体。因此,它不是一种综合征,而是一种疾病分类实体,一种独特的疾病,由单个常染色体基因引起。植烷酸积累在这种疾病中的重要性最早由克伦克和卡尔克证明。据作者所知,尚未有报道称存在具有多神经炎型共济失调性遗传病所有典型症状和体征且无任何非典型临床特征的病例,而不伴有植烷酸代谢紊乱。饮食疗法(低叶绿醇、低植烷酸饮食)最早由埃尔贾恩提出,当时初步实验结果表明植烷酸来源于外源性。无论植烷酸积累与多神经炎型共济失调性遗传病临床表现之间的生化机制如何,成功饮食治疗后对患者的观察结果似乎很有说服力,几乎毫无疑问,这种疾病的大多数(如果不是全部)表现都是由植烷酸积累以某种方式引起的。