Suárez-Cuervo A, Salas-Puig J, Alvarez V, Coto E, Fernández J M, Lahoz C H
Servicio de Neurología, Hospital General de Asturias, Oviedo.
Neurologia. 1998 Oct;13(8):382-7.
Episodic familial ataxia type 2 is caused by mutations in the gene CACNA1A, in chromosome 19p, that codifies part of a calcium channel. We report a family affected by this disease.
Nine members of this pedigree, all of them symptomatic, were seen and followed by us, including a magnetic resonance scan in all the cases but one. We performed linkage analysis to markers close or included in the gene CACNA1A.
All of the patients had brief, self-limiting attacks of ataxia, that usually started between the ages of 8 and 12. Other symptoms frequently associated were dysarthria, headache, nausea and somnolence. Only one patient, with severe alcoholic intake, developed progressive ataxia after several years with self-limiting attacks. The remaining cases had nystagmus in lateral gaze as the only abnormality on examination. Acetazolamide decreased or eliminated the attacks in those patients treated. Magnetic resonance scans always showed cerebellar vermian atrophy. Genetic study confirmed linkage to gene CACNA1A.
We emphasize the importance in knowing about this disease, with an easily identifiable clinical and neuroimaging pattern, and an efficient symptomatic treatment.
发作性家族性2型共济失调由位于19号染色体短臂上的CACNA1A基因突变引起,该基因编码钙通道的一部分。我们报告了一个受此病影响的家族。
我们对该家系中的9名成员进行了诊治和随访,他们均有症状,除1例患者外,其余患者均进行了磁共振扫描。我们对CACNA1A基因附近或包含该基因的标记进行了连锁分析。
所有患者均有短暂的、自限性的共济失调发作,通常始于8至12岁。常见的其他伴随症状有构音障碍、头痛、恶心和嗜睡。只有1例严重酗酒的患者在数年的自限性发作后出现了进行性共济失调。其余病例在检查中仅发现侧视时眼球震颤这一异常。乙酰唑胺可减轻或消除接受治疗患者的发作。磁共振扫描始终显示小脑蚓部萎缩。基因研究证实与CACNA1A基因连锁。
我们强调了解这种疾病的重要性,其具有易于识别的临床和神经影像学特征,以及有效的对症治疗方法。