title: Late-onset mental deterioration and fluctuating dystonia in a female patient with a truncating MECP2 mutation.
abstract: A 26-year-old woman with psychomotor developmental delay since late infancy showed rapid deterioration of her psychomotor abilities at the 11 years of age. She had gained the ability to verbally express herself and perform motor activities such as running and dancing in early childhood, but she lost the ability to verbally communicate and was unable to walk independently after this period. She also presented with dystonia in the right extremities, which markedly fluctuated with a periodicity of hours to months. Sleep disturbance and epileptic seizures also emerged during adolescence. Frontal lobe atrophy and hypoperfusion of the left cerebral hemisphere were noted on neuroimaging examinations. Analysis of the MECP2 gene revealed a late truncating mutation of c.1196_1200delCCACC (p.P399QfsX4) near the 3'-terminal of the coding region. The phenotype of this patient corresponds to the rare, unestablished variant of "late childhood deterioration" in MECP2-related disorders. For the first time, MECP2 mutation was confirmed to be the genetic basis of this condition.
authors: Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8551, Japan.
authors: Eri
authors: E
authors: Takeshita
authors: Yoshiaki
authors: Y
authors: Saito
authors: Eiji
authors: E
authors: Nakagawa
authors: Hirofumi
authors: H
authors: Komaki
authors: Kenji
authors: K
authors: Sugai
authors: Masayuki
authors: M
authors: Sasaki
authors: Atsuo
authors: A
authors: Nezu
authors: Junichi
authors: J
authors: Kitamura
authors: Masayuki
authors: M
authors: Itoh
authors: Yoshie
authors: Y
authors: Sawano
authors: Yu-ichi
authors: Y
authors: Goto
mesh_terms: D000328:Adult; D004421:Dystonia / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology; D005260:Female; D006801:Humans; D051783:Methyl-CpG-Binding Protein 2 / Q000235:genetics*; D009154:Mutation / Q000235:genetics*; D015518:Rett Syndrome / Q000175:diagnosis* / Q000235:genetics* / Q000523:psychology
chemical_list: C497392:MECP2 protein, human; D051783:Methyl-CpG-Binding Protein 2