Hereditary Ataxias



Hereditary Ataxias





See Table 108.1 for list of disorders; Tables 108.2, 108.3 for clinical features and inheritance. Notes about selected conditions follow.








Table 108.1 Hereditary Ataxias by Mode of Inheritance










































































































Autosomal Recessive Ataxias
(onset usually before age 20, although some have late-onset forms)
Friedreich ataxia (FRDA)
Ataxia telangiectasia (AT)
Ataxia with vitamin E deficiency (AVED)
Abeta and hypobetalipoproteinemia
AOA1 (ataxia with oculomotor apraxia 1)
AOA2 (ataxia with oculomotor apraxia 2)
ARSACS (autosomal recessive spastic ataxia of Charlevoix Saguenay)
IOSCA (infantile onset cerebellar ataxia)
Ataxia-telangiectasia variant (ATV1)/Nijmegen Breakage Syndrome
Spinocerebellar ataxia with neuropathy
Other Recessive Ataxias
   With hypogonadism
   With myoclonus
   With optic atrophy and mental retardation
   With deafness
   With cataracts and mental retardation (Marinesco-Sjögren)
Childhood ataxia with CNS hypomyelination/vanishing white matter (CACH)
Carboxylase deficiencies
Urea cycle defects
Aminoacidurias
Biotinidase deficiency
Wilson disease
Hypoceruloplasminemia with ataxia and dysarthria (onset in 40s)
Sialidosis
Refsum
Ceroid lipofuscinosis (Batten disease)
Leukodystrophies
Cerebrotendinous xanthomatosis
Hexosaminidase deficiency
Xeroderma pigmentosum
Cockayne syndrome
Leigh (also mitochondrial inheritance)
X-Linked
Fragile X-Tremor Ataxia
X-linked sideroblastic anemia with ataxia
Uncomplicated ataxia
Ataxia with spasticity
   With mental retardation
   With deafness
Autosomal Dominant Ataxias
Spinocerebellar ataxias:
SCA type 1, 2, 3 (Machado-Joseph disease), 4, 5, 6, 7, 8, 10, 11, 12, 13, 14, 15, 16, 17, 18, 20, 21, 25
Dentatorubral pallidoluysian atrophy (DRPLA)
Episodic ataxia type 1 (EA1)
Episodic ataxia type 2 (EA2)
Mitochondrial Inheritance
Coenzyme Q10 (Co-Q10) deficiency
Mitochondrial encephalomyopathies (MERRF, NARP, KSS)
Leigh Syndrome
KSS, Kearns-Sayre syndrome; MERRF, mitochondrial encephalomyopathy with ragged red fibers; NARP, neuropathy, ataxia, retinitis pigmentosa.








Table 108.2 Clinical Features In Selected Autosomal Recessive Ataxias






































Disorder Typical age of onset (range in years) Clinical features (all have ataxia)
Friedrich ataxia (FRDA) Childhood–teens (infant–40) Hyporeflexia, position sense loss, sensory loss, dysarthria, Babinski sign, cardiomyopathy, scoliosis; may be manifest by late-onset spastic paraparesis without much or any ataxia
Ataxia-telangiectasia (AT) Early childhood (infant to 27) Oculocutaneous telangiectasia, immunodeficiency, elevated alpha-fetoprotein, malignancy
Ataxia with oculomotor apraxia type 1 (AOA 1) 7 (2–16) Dysarthria, dysmetria, axonal neuropathy with areflexia, chorea, dystonia, decreased serum albumin and total cholesterol
Ataxia with oculomotor apraxia type 2 (AOA2) 15 (10–25) Sensorimotor neuropathy, oculomotor apraxia, chorea, dystonia, increased alpha-fetoprotein
Autosomal recessive spastic ataxia of Charlevoix Saguenay (ARSACS) Childhood Retinal striations, spasticity, peripheral neuropathy
Infantile onset spinocerebellar ataxia (IOSCA) Infancy Peripheral neuropathy, chorea, optic atrophy, hearing loss
Marinesco- Sjögren Infancy Cataracts, mental retardation, hypotonia, myopathy
Ataxia with Vitamin E Deficiency (AVED) Child to teen (2–52) FRDA-like, titubation

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Jul 27, 2016 | Posted by in NEUROLOGY | Comments Off on Hereditary Ataxias

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