Sue W C, Hwu W L, Chen C Y
Department of Pediatrics, Taipei Municipal Women and Children's Hospital, Taipei, Taiwan.
Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi. 1998 Sep-Oct;39(5):342-5.
Huntington's disease (HD) is caused by mutation of the IT 15gene (chromosome 4p16.3), with elongation of (CAG) n repeats. Most juvenile Huntington disease patients acquire the genetic defect through paternal transmission due to amplification of the repeat number during spermatogenesis, and thus causing early age of disease onset and increased disease severity. We here report one case that instead of choreoathetosis presents symptoms of developmental regression, such as seizure and rigid/bradykinesia. EEG showed occipital dominant 4-5 Hz high-amplitude spike-wave activities. MRI showed advanced atrophy and abnormal increase in signal intensity on T2-weighted and proton-density-weighted images of the caudate nuclei and putamina early in the course. The clinical diagnosis is confirmed by PCR study of HD (CAG) n repeats. This is the first case of juvenile Hunington's disease reported in Taiwan.
亨廷顿舞蹈症(HD)由IT 15基因(4号染色体p16.3)突变引起,伴有(CAG)n重复序列的延长。多数青少年型亨廷顿舞蹈症患者因精子发生过程中重复序列数目的扩增,通过父系遗传获得该基因缺陷,进而导致发病年龄提前且疾病严重程度增加。我们在此报告1例患者,其未表现出舞蹈徐动症,而是出现发育倒退症状,如癫痫发作和强直/运动迟缓。脑电图显示枕叶占优势的4 - 5赫兹高振幅棘波活动。磁共振成像显示病程早期尾状核和壳核在T2加权像和质子密度加权像上出现晚期萎缩且信号强度异常增加。通过对HD(CAG)n重复序列的聚合酶链反应研究确诊了该临床诊断。这是台湾地区报道的首例青少年型亨廷顿舞蹈症病例。