title: Remarkable motor recovery after riboflavin therapy in adult-onset Brown-Vialetto-Van Laere syndrome.
abstract: The clinical diagnosis of Brown-Vialetto-Van Laere syndrome in this woman with rapidly progressive pontobulbar palsy led to empirical high-dose oral riboflavin (1200 mg/day) therapy. This resulted in a dramatic improvement in her motor function from being anarthric, dysphagic, tetraparetic and in ventilatory failure to living independently with mild dysarthria and distal limb weakness. DNA sequencing of the SLC52A3 gene found compound heterozygous C-terminus mutations, V413A1/D461Y, consistent with recent reports of mutations within the riboflavin transporter genes (SLC52A2 and SLC52A3) in this condition. Early diagnosis and empirical riboflavin therapy can lead to major motor recovery in this condition, that can be sustained with long-term maintenance therapy.
authors: Maurice Wohl Clinical Neuroscience Institute, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
authors: James A
authors: JA
authors: Bashford
authors: Neurology Department, St George's University Hospitals NHS Foundation Trust, London, UK.
authors: Fahmida A
authors: FA
authors: Chowdhury
authors: Maurice Wohl Clinical Neuroscience Institute, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.
authors: Chris E
authors: CE
authors: Shaw
mesh_terms: D000328:Adult; D010244:Bulbar Palsy, Progressive / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D009048:Motor Skills / Q000187:drug effects* / Q000502:physiology; D020127:Recovery of Function / Q000187:drug effects* / Q000502:physiology; D012256:Riboflavin / Q000494:pharmacology / Q000627:therapeutic use*; D014803:Vitamin B Complex / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D014803:Vitamin B Complex; D012256:Riboflavin
keywords: NEUROGENETICS; NEUROMUSCULAR; SPEECH