title: Clinical and molecular findings of ataxia with oculomotor apraxia type 2 in 4 families.
abstract: BACKGROUND
  Ataxia with oculomotor apraxia type 2 (AOA2) is an autosomal recessive disease caused by SETX mutations in 9q34 resulting in cerebellar ataxia in association with peripheral neuropathy, cerebellar atrophy on imaging, an elevated alpha-fetoprotein (AFP) serum level, and occasional oculomotor apraxia.
  
  
  OBJECTIVE
  To describe the clinical and molecular findings of 7 patients with a clinical presentation of AOA2 and their relatives.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Projet Hospitalier de Recherche Clinique.
  
  
  METHODS
  Seven patients with AOA2 and their family members.
  
  
  METHODS
  Linkage analysis and direct sequencing of all exons of SETX were performed in all patients. Magnetic resonance imaging and electroneuromyography were performed and the patients' AFP serum levels were tested.
  
  
  RESULTS
  We identified 7 patients with AOA2 from 4 unrelated families. Three novel SETX mutations were found. The clinical picture of the patients reported is fairly homogeneous and in accordance with the classic AOA2 presentation: onset from 13 to 18 years of progressive cerebellar ataxia and areflexia. Oculomotor apraxia was detected in 1 patient. Predominant axonal neuropathy and a diffuse cerebellar atrophy were found in the 4 patients tested. All patients had elevated AFP serum levels and 5 of 8 nonsymptomatic heterozygous relatives had moderately increased AFP serum levels as well.
  
  
  CONCLUSIONS
  Ataxia with oculomotor apraxia type 2 is a homogeneous form of cerebellar ataxia with occasional oculomotor apraxia. Most nonsymptomatic heterozygous carriers present with increased AFP serum levels.
authors.affiliation: Département de Neurologie, Hôpital Civil, 1 Place de l'Hôpital, 67091 Strasbourg, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Anheim
authors.forename: Marie-Celine
authors.initials: MC
authors.lastname: Fleury
authors.forename: Jerome
authors.initials: J
authors.lastname: Franques
authors.forename: Maria-Ceu
authors.initials: MC
authors.lastname: Moreira
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Delaunoy
authors.forename: Dominique
authors.initials: D
authors.lastname: Stoppa-Lyonnet
authors.forename: Michel
authors.initials: M
authors.lastname: Koenig
authors.forename: Christine
authors.initials: C
authors.lastname: Tranchant
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000595:Amino Acid Sequence; D001072:Apraxias / Q000150:complications / Q000175:diagnosis / Q000235:genetics*; D001259:Ataxia / Q000150:complications / Q000175:diagnosis / Q000235:genetics*; D002648:Child; D005260:Female; D008040:Genetic Linkage / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009154:Mutation; D015840:Oculomotor Nerve Diseases / Q000150:complications / Q000175:diagnosis / Q000235:genetics*; D010375:Pedigree