Autosomal dominant childhood onset slowly progressive leukodystrophy--a Japanese family with spastic paraparesis, ataxia, mental deterioration, and skeletal abnormality.
Autosomal dominant leukodystrophy is an extremely rare disease. Here we report on a dominantly inherited disease in a Japanese family with slowly progressive clinical course. Their symptoms and signs started in early childhood and very slowly progressed. In most patients spastic gait was the initial symptom. Neurological manifestations were characterized by pyramidal signs, ataxia, and mental deterioration. In addition to these neurological signs, the skeletal anomalies such as scoliosis and congenital hip dislocation were also present. MR images showed no abnormality in the early stage, but T2-weighted images revealed high intensity areas in the cerebral and cerebellar white matter, and the dentate nucleus in the advanced stage. Proton MR spectroscopy showed decrease of N-acetylaspartate/creatine ratio and increase of choline/creatine ratio in the advanced stage. Proton MR spectroscopy revealed normal N-acetylaspartate/creatine ratio and increase of choline/creatine ratio in the early stage. We suggested that these patients had abnormality in the white matter when MRI was still normal. We considered that intracranial demyelination was gradually progressed as the symptoms got aggravated.
Nomoto
Nobuatsu
N
Fourth Department of Internal Medicine, Toho University School of Medicine Ohashi Hospital, 2-17-6 Ohashi, Meguro, Tokyo 153-8515, Japan. nobu@med.toho-u.ac.jp
Iwasaki
Yasuo
Y
Arasaki
Keisuke
K
Fujioka
Toshiki
T
Kurihara
Teruyuki
T
Wakata
Nobuo
N
D000293:Adolescent; D000328:Adult; D001259:Ataxia / Q000235:genetics*; D001842:Bone and Bones / Q000002:abnormalities*; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000235:genetics*; D007564:Japan; D007965:Leukodystrophy, Globoid Cell / Q000235:genetics*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020336:Paraparesis, Spastic / Q000235:genetics*; D010375:Pedigree