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KIF1A‐related disorders in children: A wide spectrum of central and peripheral nervous system involvement
Authors:Tarishi Nemani  Dora Steel  Marios Kaliakatsos  Catherine DeVile  Athina Ververi  Richard Scott  Spas Getov  Sniya Sudhakar  Alison Male  Kshitij Mankad    Francesco Muntoni  Mary M Reilly  Manju A Kurian  Lucinda Carr  Pinki Munot
Abstract:KIF1A‐related disorders (KRD) were first described in 2011 and the phenotypic spectrum has subsequently expanded to encompass a range of central and peripheral nervous system involvement. Here we present a case series demonstrating the range of clinical, neurophysiological, and radiological features which may occur in childhood‐onset KRD. We report on all the children and young people seen at a single large tertiary centre. Data were collected through a retrospective case‐notes review. Twelve individuals from 10 families were identified. Eight different mutations were present, including four novel mutations. Two patients displayed a very severe phenotype including congenital contractures, severe spasticity and/or dystonia, dysautonomia, severe sensorimotor polyneuropathy and optic atrophy, significant white matter changes on brain MRI, respiratory insufficiency, and complete lack of neurodevelopmental progress. The remaining 10 patients represented a spectrum of severity with common features including a movement disorder with spasticity and/or dystonia, subtle features of dysautonomia, sensory axonal neuropathy, varying degrees of optic atrophy and of learning and/or behavioural difficulties, and subtle or absent—but sometimes progressive—changes in white matter on MRI. Epilepsy was common among the more severely affected children. This case series demonstrates that KRD comprise a range of neurological disorders, with both the milder and the more severe forms combining central and peripheral (including autonomic) nervous system deficits.
Keywords:dysautonomia  dystonia  hereditary spastic paraparesis     KIF1A  neuropathy
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