Movement Disorders (revue)

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Stiff man–like syndrome and generalized myokymia in spinocerebellar ataxia type 3

Identifieur interne : 003180 ( Main/Exploration ); précédent : 003179; suivant : 003181

Stiff man–like syndrome and generalized myokymia in spinocerebellar ataxia type 3

Auteurs : José Berciano [Espagne] ; Jon Infante [Espagne] ; Antonio García [Espagne] ; Carmen De Pablos [Espagne] ; Guillermo Amer [Espagne] ; José Miguel Polo [Espagne] ; Victor Volpini [Espagne] ; Onofre Combarros [Espagne]

Source :

RBID : ISTEX:51681A64CEFF3A704323A1946770C9811385209A

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Abstract

We describe the novel association of spinocerebellar ataxia type 3/Machado–Joseph disease (SCA3/MJD) phenotype combining classical clinical presentation and semeiology mimicking stiff man syndrome (SMS). The studied pedigree comprises seven affected members in three generations. Their clinical picture consisted of cerebellar ataxia, pyramidal signs, facial myokymia, and ophthalmoplegia. The proband was a 39‐year‐old man in whom such a clinical picture, 5 years after onset at age 29, evolved to severe SMS and widespread myokymia. Electrophysiological study revealed continuous muscle activity in proximal limb muscles. Molecular study demonstrated the MJD gene mutation in all four examined patients with 73 to 76 CAG repeats in the expanded allele. We conclude that an excess of motor unit activity including stiff man–like syndrome and widespread myokymia may be an integral part of the SCA3 clinical spectrum. © 2006 Movement Disorder Society

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DOI: 10.1002/mds.20865


Affiliations:


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Le document en format XML

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<term>Adult</term>
<term>Aged</term>
<term>Alleles</term>
<term>Atrophy</term>
<term>Brain Stem (pathology)</term>
<term>Cerebellum (pathology)</term>
<term>Diagnosis, Differential</term>
<term>Disease Progression</term>
<term>Female</term>
<term>Humans</term>
<term>Joseph disease</term>
<term>Machado-Joseph Disease (diagnosis)</term>
<term>Machado-Joseph Disease (genetics)</term>
<term>Machado–Joseph disease</term>
<term>Magnetic Resonance Imaging</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Myoclonus</term>
<term>Myokymia</term>
<term>Myokymia (diagnosis)</term>
<term>Myokymia (genetics)</term>
<term>Nerve Tissue Proteins (genetics)</term>
<term>Nervous system diseases</term>
<term>Neurologic Examination</term>
<term>Nuclear Proteins (genetics)</term>
<term>Ophthalmoplegia (diagnosis)</term>
<term>Ophthalmoplegia (genetics)</term>
<term>Oscillopsia</term>
<term>Pedigree</term>
<term>Phenotype</term>
<term>Repressor Proteins (genetics)</term>
<term>Spinocerebellar ataxia</term>
<term>Stiff man syndrome</term>
<term>Stiff-Person Syndrome (diagnosis)</term>
<term>Stiff-Person Syndrome (genetics)</term>
<term>Tomography, X-Ray Computed</term>
<term>dysautonomia</term>
<term>facial action myoclonus</term>
<term>myokymia</term>
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<term>Ophthalmoplegia</term>
<term>Stiff-Person Syndrome</term>
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<term>Aged</term>
<term>Alleles</term>
<term>Atrophy</term>
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<term>Middle Aged</term>
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<term>Phenotype</term>
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<term>Ataxie spinocérébelleuse</term>
<term>Homme raide syndrome</term>
<term>Joseph maladie</term>
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<div type="abstract" xml:lang="en">We describe the novel association of spinocerebellar ataxia type 3/Machado–Joseph disease (SCA3/MJD) phenotype combining classical clinical presentation and semeiology mimicking stiff man syndrome (SMS). The studied pedigree comprises seven affected members in three generations. Their clinical picture consisted of cerebellar ataxia, pyramidal signs, facial myokymia, and ophthalmoplegia. The proband was a 39‐year‐old man in whom such a clinical picture, 5 years after onset at age 29, evolved to severe SMS and widespread myokymia. Electrophysiological study revealed continuous muscle activity in proximal limb muscles. Molecular study demonstrated the MJD gene mutation in all four examined patients with 73 to 76 CAG repeats in the expanded allele. We conclude that an excess of motor unit activity including stiff man–like syndrome and widespread myokymia may be an integral part of the SCA3 clinical spectrum. © 2006 Movement Disorder Society</div>
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