title: R583Q CACNA1A variant in SHM1 and ataxia: case report and literature update.
abstract: Familial hemiplegic migraine (FHM) type 1 is a rare monogenic dominant autosomal disease due to CACNA1A gene mutations. Besides the classical phenotype, mutations on CACNA1A gene are associated with a broader spectrum of clinical features including cerebellar ataxia, making FHM1 a complex channelopathy. We report the case of a patient carrying the p.Arg583Gln mutation affected by hemiplegic migraine and late onset ataxia and we performed a literature review about the clinical features of p.Arg583Gln. Although p.Arg583Gln mutations are associated with a heterogeneous phenotype, carriers present cerebellar signs which consisted generally in ataxia and dysmetria, with intention tremor appearing mostly in advanced age, often progressive and permanent. The heterogeneous spectrum of CACNA1A gene mutations probably causes sporadic hemiplegic migraine (SHM) to be misdiagnosed. Given the therapeutic opportunities, SHM/FHM1 should be considered in differential diagnosis of patients with cerebellar ataxia and migraine with aura.
authors.affiliation: Department of Neurosurgery, University of Milan, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Cristofori
authors.forename: Laura
authors.initials: L
authors.lastname: Fusi
authors.forename: Antonella
authors.initials: A
authors.lastname: Gomitoni
authors.forename: Giampiero
authors.initials: G
authors.lastname: Grampa
authors.forename: Anna
authors.initials: A
authors.lastname: Bersano
mesh_terms: D001120:Arginine / Q000235:genetics*; D001259:Ataxia / Q000150:complications / Q000235:genetics*; D015220:Calcium Channels / Q000235:genetics*; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000473:pathology; D004252:DNA Mutational Analysis; D005260:Female; D005973:Glutamine / Q000235:genetics*; D006801:Humans; D008875:Middle Aged; D020325:Migraine with Aura / Q000150:complications / Q000235:genetics*; D011859:Radiography; D015898:Tomography Scanners, X-Ray Computed; D020864:Calcium Channels, N-Type
chemical_list: D001120:Arginine; D015220:Calcium Channels; D005973:Glutamine; C105656:CACNA1A protein, human; D020864:Calcium Channels, N-Type