title: Should spinocerebellar ataxias be included in the differential diagnosis for Huntington's diseases-like syndromes?
abstract: In this article, we describe three patients with different spinocerebellar ataxia (SCA) subtypes presenting with unusual movement disorders predominantly characterized by choreoathetosis, which, together with their autosomal dominant pattern of inheritance, resembled the Huntington-like syndromes. From a large SCA cohort, we have observed chorea in 1/35 SCA2, 1/112 SCA3/MJD, and 1/30 SCA7 patients. Twenty-eight patients with SCA1, 11 patients with SCA6, and 3 patients with SCA10 were also evaluated, and none of them presented chorea. We provide a brief report of the three cases, with a video demonstrating chorea. Although a debate regarding the frequency of chorea in SCA patients is a fact, its occurrence, together with the autosomal dominant pattern of inheritance, clearly imposes SCA in the differentials of Huntington-like syndromes. There is some debate about what to include in a list of Huntington-like disorders, with several review articles about Huntington-like syndromes not including SCA in the differential diagnosis, except for SCA17. We believe that SCAs-at least SCA1, SCA2, SCA3/MJD, SCA7 and DRPLA-should be thought in the diagnostic workout of at least the atypical cases, such as those presented in this report.
authors.affiliation: Department of Neurology, Ataxia Unit, Universidade Federal de São Paulo, Brazil. Electronic address: jlpedroso.neuro@gmail.com.
authors.forename: José Luiz
authors.initials: JL
authors.lastname: Pedroso
authors.affiliation: Department of Neurology, Ataxia Unit, Universidade Federal de São Paulo, Brazil.
authors.forename: Maria Eliza Thomaz
authors.initials: ME
authors.lastname: de Freitas
authors.affiliation: Department of Neurology, Ataxia Unit, Universidade Federal de São Paulo, Brazil.
authors.forename: Marcus Vinicius Cristino
authors.initials: MV
authors.lastname: Albuquerque
authors.affiliation: Department of Biochemistry and Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Maria Luiza
authors.initials: ML
authors.lastname: Saraiva-Pereira
authors.affiliation: Department of Internal Medicine and Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Laura Bannach
authors.initials: LB
authors.lastname: Jardim
authors.affiliation: Department of Neurology, Ataxia Unit, Universidade Federal de São Paulo, Brazil.
authors.forename: Orlando G P
authors.initials: OG
authors.lastname: Barsottini
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009419:Nerve Tissue Proteins / Q000235:genetics; D020754:Spinocerebellar Ataxias / Q000145:classification* / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology; D013577:Syndrome
chemical_list: D009419:Nerve Tissue Proteins; C095278:atrophin-1
keywords: Autosomal dominant; Chorea; Huntington-like syndromes; Movement disorders; SCA; Spinocerebellar ataxia