Joubert syndrome surviving to adulthood associated with a progressive movement disorder.
A 48-year-old man presented with a progressive gait disorder. He had longstanding ataxia, oculomotor apraxia, motor delay, and cognitive impairment, diagnosed as cerebral palsy. Physical examination revealed ataxia, oculomotor apraxia, extrapyramidal signs, and a wide-based, shuffling gait. Magnetic resonance imaging showed vermian aplasia, consistent with Joubert syndrome. Positron emission tomography scan revealed normal fluorodopa uptake, but elevated raclopride binding, compatible with dopamine deficiency. This case demonstrates that a patient with Joubert syndrome may survive into adulthood and present as a chronic neurologic disorder with subacute extrapyramidal signs.
Gunzler
Steven A
SA
Parkinson's Disease Research, Education, and Clinical Center, Portland VA Medical Center, Portland, Oregon, USA. gunzlers@ohsu.edu
Stoessl
A Jon
AJ
Egan
Robert A
RA
Weleber
Richard G
RG
Wang
Paul
P
Nutt
John G
JG
D000367:Age Factors; D001259:Ataxia / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D002531:Cerebellum / Q000002:abnormalities; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis; D018450:Disease Progression; D005116:Extrapyramidal Tracts / Q000503:physiopathology; D019066:Facies; D006801:Humans; D018476:Hypokinesia / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009759:Nystagmus, Pathologic / Q000150:complications / Q000503:physiopathology; D015840:Oculomotor Nerve Diseases / Q000150:complications*; D012720:Severity of Illness Index; D013064:Speech Disorders / Q000150:complications; D013577:Syndrome