[A sporadic dentatorubral-pallidoluysian atrophy (DRPLA) diagnosed by gene analysis].
We report a 48-year-old woman with dentatorubral-pallidoluysian atrophy (DRPLA). She is the only patient in her 15 family members in two generations. She developed cerebellar ataxia and epilepsy at age 43. On admission at 48, she showed mild dementia and choreic movement in her face and extremities as well as truncal and limb ataxia. Routine laboratory examinations were normal. The point mutations in the tRNALys gene of mitochondrial DNA specific for MERRF were not found. A cranial CT scan and MRI showed mild atrophy of the cerebellum and prominent atrophy in the pons, especially in the tegmentum. Although she was thought to have DRPLA from the clinical point of view, absence of family history made the diagnosis difficult. Her parents were healthy until their 80's and died of cerebrovascular diseases and her 5 siblings had no symptoms. Hereditary DRPLA is known as an autosomal dominant disorder, with a high rate of penetrance and low rate of new mutation. According to our recent findings of a CAG repeat expansion in the DRPLA gene, this patient was diagnosed as a sporadic DRPLA. Considering the wide varieties of clinical manifestations, it is essential to examine this gene abnormality for diagnosing sporadic DRPLA.
Yoshimoto
H
H
Department of Neurology, Niigata University School of Medicine.
Sahara
M
M
Tanaka
K
K
Ikeuchi
T
T
Koide
R
R
Tsuji
S
S
D001284:Atrophy; D001927:Brain Diseases / Q000175:diagnosis*; D002524:Cerebellar Ataxia / Q000209:etiology; D002529:Cerebellar Nuclei; D004827:Epilepsy / Q000209:etiology; D005260:Female; D005917:Globus Pallidus; D006801:Humans; D008875:Middle Aged; D018598:Minisatellite Repeats; D012012:Red Nucleus