[A case of late adult-onset dentatorubral-pallidoluysian atrophy (DRPLA) successfully treated with V-P shunt operation].
A 44-year-old Japanese man was diagnosed as having late adult-onset dentatorubral-pallidoluysian atrophy (DRPLA), whose CAG repeats in the DRPLA gene were 60 and 15. He developed gait disturbance, limb ataxia, pyramidal tract signs, dementia, and psychiatric symptoms including character changes within a few years of the above diagnosis. His T 2-weighted brain MRI showed symmetric high-signal lesions in the cerebral white matter and brain stem, in addition to cerebellar, brain stem, and cerebral cortical atrophy. Since the results of RI cisternography indicated that he manifested the clinical features of normal pressure hydrocephalus (NPH), V-P shunt operation was done. In a week after the operation, his gait disturbance, pyramidal tract signs, dementia and psychiatric symptoms were remarkably improved. White matter lesions have been thought to be concomitant with late adult-onset DRPLA patients, but some of these patients may have characteristics of NPH pathophysiology.
Fujita
N
N
Department of Neurology, Nagaoka Red Cross Hospital.
Tabe
H
H
Shimohata
T
T
Makino
K
K
Nagai
H
H
D000328:Adult; D001284:Atrophy; D001921:Brain / Q000473:pathology; D018891:Dentate Gyrus / Q000473:pathology*; D005917:Globus Pallidus / Q000473:pathology*; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000209:etiology* / Q000601:surgery*; D008297:Male; D012012:Red Nucleus / Q000473:pathology*; D016896:Treatment Outcome; D018911:Trinucleotide Repeats; D017287:Ventriculoperitoneal Shunt