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Mastrangelo A, Giannoccaro MP, Donadio V, Ricciardiello F, Di Laudo F, Palombo F, Liguori R, Rizzo G. Progressive Ataxia and Palatal Tremor Is Not Associated with IgLON5 Antibodies: Results From Two Cases. CEREBELLUM (LONDON, ENGLAND) 2024; 23:1718-1721. [PMID: 38060151 DOI: 10.1007/s12311-023-01647-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 12/08/2023]
Abstract
Progressive ataxia and palatal tremor (PAPT) and anti-IgLON5 disease share possible clinical presentations. Furthermore, both have been associated to a tauopathy mainly affecting the brainstem. Nonetheless, anti-IgLON5 antibodies have never been tested in PAPT. We report on two PAPT cases without evidence of anti-IgLON5 antibodies in both CSF and serum. Despite common clinical and pathological characteristics, PAPT and IgLON5 disease are two distinct entities.
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Affiliation(s)
- Andrea Mastrangelo
- Department of Biomedical and Neuromotor Sciences, University of Bologna (DIBINEM), Bologna, Italy
| | - Maria Pia Giannoccaro
- Department of Biomedical and Neuromotor Sciences, University of Bologna (DIBINEM), Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
| | - Vincenzo Donadio
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
| | - Fortuna Ricciardiello
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
| | - Felice Di Laudo
- Department of Biomedical and Neuromotor Sciences, University of Bologna (DIBINEM), Bologna, Italy
| | - Flavia Palombo
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Programma di Neurogenetica, Ospedale Bellaria, Via Altura 1/8, 40139, Bologna, Italy
| | - Rocco Liguori
- Department of Biomedical and Neuromotor Sciences, University of Bologna (DIBINEM), Bologna, Italy
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy
| | - Giovanni Rizzo
- IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Clinica Neurologica, Bologna, Italy.
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2
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Ghosh R, León-Ruiz M, Dubey S, Benito-León J. The first case report of spinocerebellar ataxia type-40 in India: novel phenotypic and radiological (bilateral olivary degeneration) features and a comprehensive review of this remarkable radiological sign. Neurol Sci 2022; 43:5111-5117. [DOI: 10.1007/s10072-022-06095-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 04/20/2022] [Indexed: 11/29/2022]
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3
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Freitas LF, de Carvalho VM, Pedroso JL, Duarte ML, Massaud RM. Simultaneous mixed phenotype and neuroimaging of progressive supranuclear palsy, progressive ataxia and palatal tremor: two different faces of tauopathies. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:656-657. [PMID: 35946715 PMCID: PMC9387190 DOI: 10.1590/0004-282x-anp-2021-0442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/12/2021] [Accepted: 12/29/2021] [Indexed: 06/15/2023]
Affiliation(s)
| | | | - José Luiz Pedroso
- Universidade Federal de São Paulo, Departamento de Neurologia, São Paulo SP, Brazil
| | - Márcio Luís Duarte
- Universidade Federal de São Paulo, Departamento de Saúde Baseada em Evidências, São Paulo SP, Brazil
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4
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Tezuka T, Takahata K, Tagai K, Ueda R, Ito D, Takeda H, Takahashi S, Nakahara J, Higuchi M, Seki M. Progressive Ataxia and Palatal Tremor Showing Characteristic Tau Depositions in [ 18 F]PM-PBB3 PET. Mov Disord 2022; 37:1317-1319. [PMID: 35274378 DOI: 10.1002/mds.28983] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Toshiki Tezuka
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Keisuke Takahata
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum and Radiological Science and Technology (QST), Chiba, Japan
| | - Kenji Tagai
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum and Radiological Science and Technology (QST), Chiba, Japan
| | - Ryo Ueda
- Office of Radiation Technology, Keio University Hospital, Tokyo, Japan
| | - Daisuke Ito
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Hidetaka Takeda
- Department of Training System for Nurses Pertaining to Specified Acts, International University of Health and Welfare, Tokyo, Japan
| | - Shinichi Takahashi
- Department of Neurology and Cerebrovascular Medicine, Saitama Medical University International Medical Center, Saitama, Japan
| | - Jin Nakahara
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Makoto Higuchi
- Department of Functional Brain Imaging, Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institutes for Quantum and Radiological Science and Technology (QST), Chiba, Japan
| | - Morinobu Seki
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
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5
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Kovacs GG, Ghetti B, Goedert M. Classification of Diseases with Accumulation of Tau Protein. Neuropathol Appl Neurobiol 2022; 48:e12792. [PMID: 35064600 PMCID: PMC9352145 DOI: 10.1111/nan.12792] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 01/07/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Gabor G Kovacs
- Tanz Centre for Research in Neurodegenerative Disease and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.,Laboratory Medicine Program & Krembil Brain Institute, University Health Network, Toronto, Ontario, Canada
| | - Bernardino Ghetti
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indiana, USA
| | - Michel Goedert
- MRC Laboratory of Molecular Biology, Francis Crick Avenue, Cambridge, UK
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6
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Deuschl G, Becktepe JS, Dirkx M, Haubenberger D, Hassan A, Helmich R, Muthuraman M, Panyakaew P, Schwingenschuh P, Zeuner KE, Elble RJ. The clinical and electrophysiological investigation of tremor. Clin Neurophysiol 2022; 136:93-129. [DOI: 10.1016/j.clinph.2022.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 01/18/2023]
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7
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Surisetti BK, Prasad S, Holla VV, Neeraja K, Kamble N, Netravathi M, Yadav R, Pal PK. Clinical and Imaging Profile of Patients with Palatal Tremor. Mov Disord Clin Pract 2021; 8:435-444. [PMID: 33816674 DOI: 10.1002/mdc3.13173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/19/2021] [Accepted: 01/30/2021] [Indexed: 12/26/2022] Open
Abstract
Background Palatal tremor (PT) is an uncommon movement disorder that may be classified into symptomatic (SPT) or essential (EPT). The etiology of SPT is varied, with involvement of the Guillain-Mollaret triangle (GMT) and inferior olivary hypertrophy. EPT is associated with ear clicks and normal imaging and may have a functional basis. Objectives This study aims to explore the clinical and radiological features of a large cohort of patients with PT. Methods This is a retrospective chart review of patients with PT who were evaluated by the movement disorders subspeciality of the neurology department. Demographic, clinical, and imaging details of patients with PT were documented. Results A total of 22 patients with PT comprising 17 with SPT and 5 with EPT were included in this study. No patient was aware of the PT. Ear clicks were reported in 2 patients with SPT and in 3 patients with EPT. The most common etiology for SPT was vascular, followed by degenerative conditions. Patients with SPT had associated features such as tremor (70.6%), ataxia (64.7%), dystonia (52.9%), myoclonus (17.6%), and eye movement abnormalities (75%). Lesions involving the GMT were found in 82% of patients with SPT. Apart from PT, patients with EPT had no other motor symptoms, and imaging was normal. Of the patients with EPT, 2 had additional functional movement disorders. Conclusion PT has significant etiological heterogeneity and can be easily missed because of the lack of awareness by patients. Involvement of the inferior olivary nucleus may not be necessarily observed. A functional etiology should be considered in cases of EPT.
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Affiliation(s)
| | - Shweta Prasad
- Department of Neurology National Institute of Mental Health & Neurosciences Bengaluru India.,Department of Clinical Neurosciences National Institute of Mental Health & Neurosciences Bengaluru India
| | - Vikram V Holla
- Department of Neurology National Institute of Mental Health & Neurosciences Bengaluru India
| | - Koti Neeraja
- Department of Neurology National Institute of Mental Health & Neurosciences Bengaluru India
| | - Nitish Kamble
- Department of Neurology National Institute of Mental Health & Neurosciences Bengaluru India
| | - Manjunath Netravathi
- Department of Neurology National Institute of Mental Health & Neurosciences Bengaluru India
| | - Ravi Yadav
- Department of Neurology National Institute of Mental Health & Neurosciences Bengaluru India
| | - Pramod Kumar Pal
- Department of Neurology National Institute of Mental Health & Neurosciences Bengaluru India
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8
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Palatal Tremor - Pathophysiology, Clinical Features, Investigations, Management and Future Challenges. Tremor Other Hyperkinet Mov (N Y) 2020; 10:40. [PMID: 33101766 PMCID: PMC7546106 DOI: 10.5334/tohm.188] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Palatal tremor is involuntary, rhythmic and oscillatory movement of the soft palate. Palatal tremor can be classified into three subtypes; essential, symptomatic and palatal tremor associated with progressive ataxia. Methods: A thorough Pubmed search was conducted to look for the original articles, reviews, letters to editor, case reports, and teaching neuroimages, with the keywords “essential”, “symptomatic palatal tremor”, “myoclonus”, “ataxia”, “hypertrophic”, “olivary” and “degeneration”. Results: Essential palatal tremor is due to contraction of the tensor veli palatini muscle, supplied by the 5th cranial nerve. Symptomatic palatal tremor occurs due to the contraction of the levator veli palatini muscle, supplied by the 9%th and 10%th cranial nerves. Essential palatal tremor is idiopathic, while symptomatic palatal tremor occurs due to infarction, bleed or tumor within the Guillain-Mollaret triangle. Progressive ataxia and palatal tremor can be familial or idiopathic. Symptomatic palatal tremor and sporadic progressive ataxia with palatal tremor show signal changes in inferior olive of medulla in magnetic resonance imaging. The treatment options available for essential palatal tremor are clonazepam, lamotrigine, sodium valproate, flunarizine and botulinum toxin. The treatment of symptomatic palatal tremor involves the treatment of the underlying cause. Discussion: Further studies are required to understand the cause and pathophysiology of Essential palatal tremor and progressive ataxia and palatal tremor. Similarly, the link between tauopathy and palatal tremor associated progressive ataxia needs to be explored further. Oscillopsia and progressive ataxia are more debilitating than palatal tremor and needs new treatment approaches.
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9
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Gupta DK, Viñuela A, Green PH, Pitman MJ, Vonsattel JP, Fahn S. High-Frequency Palatal Tremor and Stimulus-Sensitive Leg Myoclonus with Degeneration of Inferior Olivary Nuclei in Celiac Disease. Mov Disord Clin Pract 2020; 7:S93-S95. [PMID: 33015235 PMCID: PMC7525195 DOI: 10.1002/mdc3.13079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 08/10/2020] [Accepted: 08/18/2020] [Indexed: 11/11/2022] Open
Abstract
View Supplementary Video 1
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Affiliation(s)
- Deepak K. Gupta
- Department of Neurological SciencesLarner College of Medicine at University of VermontBurlingtonVermontUSA
| | - Angel Viñuela
- Neurosciences Institute, Manati Medical CenterPonce Health Sciences UniversityPoncePuerto Rico
| | - Peter H.R. Green
- Celiac Disease CenterColumbia UniversityNew York CityNew YorkUSA
| | - Michael J. Pitman
- Division of Laryngology, Department of Head & Neck SurgeryColumbia UniversityNew York CityNew YorkUSA
| | - Jean P. Vonsattel
- NewYork Brain Bank, Department of PathologyColumbia UniversityNew York CityNew YorkUSA
| | - Stanley Fahn
- Division of Movement Disorders, Department of NeurologyColumbia UniversityNew York CityNew YorkUSA
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10
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Mulroy E, Jaunmuktane Z, Balint B, Erro R, Latorre A, Bhatia KP. Some New and Unexpected Tauopathies in Movement Disorders. Mov Disord Clin Pract 2020; 7:616-626. [PMID: 32775506 PMCID: PMC7396854 DOI: 10.1002/mdc3.12995] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/12/2020] [Accepted: 05/25/2020] [Indexed: 12/15/2022] Open
Affiliation(s)
- Eoin Mulroy
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom
| | - Zane Jaunmuktane
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom.,Division of Neuropathology, The National Hospital for Neurology and Neurosurgery University College London Hospitals National Health Service Foundation Trust London United Kingdom
| | - Bettina Balint
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom.,Department of Neurology University Hospital Heidelberg Germany
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," Neuroscience Section University of Salerno Baronissi Italy
| | - Anna Latorre
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology London United Kingdom
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11
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Magrinelli F, Latorre A, Balint B, Mackenzie M, Mulroy E, Stamelou M, Tinazzi M, Bhatia KP. Isolated and combined genetic tremor syndromes: a critical appraisal based on the 2018 MDS criteria. Parkinsonism Relat Disord 2020; 77:121-140. [PMID: 32818815 DOI: 10.1016/j.parkreldis.2020.04.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/13/2020] [Accepted: 04/18/2020] [Indexed: 12/12/2022]
Abstract
The 2018 consensus statement on the classification of tremors proposes a two-axis categorization scheme based on clinical features and etiology. It also defines "isolated" and "combined" tremor syndromes depending on whether tremor is the sole clinical manifestation or is associated with other neurological or systemic signs. This syndromic approach provides a guide to investigate the underlying etiology of tremors, either genetic or acquired. Several genetic defects have been proven to cause tremor disorders, including autosomal dominant and recessive, X-linked, and mitochondrial diseases, as well as chromosomal abnormalities. Furthermore, some tremor syndromes are recognized in individuals with a positive family history, but their genetic confirmation is pending. Although most genetic tremor disorders show a combined clinical picture, there are some distinctive conditions in which tremor may precede the appearance of other neurological signs by years or remain the prominent manifestation throughout the disease course, previously leading to misdiagnosis as essential tremor (ET). Advances in the knowledge of genetically determined tremors may have been hampered by the inclusion of heterogeneous entities in previous studies on ET. The recent classification of tremors therefore aims to provide more consistent clinical data for deconstructing the genetic basis of tremor syndromes in the next-generation and long-read sequencing era. This review outlines the wide spectrum of tremor disorders with defined or presumed genetic etiology, both isolated and combined, unraveling diagnostic clues of these conditions and focusing mainly on ET-like phenotypes. Furthermore, we suggest a phenotype-to-genotype algorithm to support clinicians in identifying tremor syndromes and guiding genetic investigations.
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Affiliation(s)
- Francesca Magrinelli
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Anna Latorre
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom.
| | - Bettina Balint
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom; Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany.
| | - Melissa Mackenzie
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom.
| | - Eoin Mulroy
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom.
| | - Maria Stamelou
- Department of Neurology, Attikon University Hospital, Athens, Greece.
| | - Michele Tinazzi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, United Kingdom.
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12
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Giagkou N, Höglinger GU, Stamelou M. Progressive supranuclear palsy. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2019; 149:49-86. [PMID: 31779824 DOI: 10.1016/bs.irn.2019.10.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Progressive supranuclear palsy (PSP) is a neurodegenerative disease characterized pathologically by 4 repeat tau deposition in various cell types and anatomical regions. Richardson's syndrome (RS) is the initially described and one of the clinical phenotypes associated with PSP pathology, characterized by vertical supranuclear gaze paly in particular downwards, postural instability with early falls and subcortical frontal dementia. PSP can manifest as several other clinical phenotypes, including PSP-parkinsonism, -pure akinesia with gait freezing, -frontotemporal dementia, - corticobasal syndrome, - speech/language impairment. RS can also have a pathologic diagnosis other than PSP, including corticobasal degeneration, FTD-TDP-43 and others. New clinical diagnostic criteria take into account this phenotypic variability in an attempt to diagnose the disease earlier, given the current lack of a validated biomarker. At present, therapeutic options for PSP are symptomatic and insufficient. Recent large neuroprotective trials have failed to provide a positive clinical outcome, however, have led to the design of better studies that are ongoing and hold promise for a neuroprotective treatment for PSP.
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Affiliation(s)
- Nikolaos Giagkou
- Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece
| | - Günter U Höglinger
- Department for Neurology Hannover Medical School (MHH), Hannover, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Maria Stamelou
- Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece; Aiginiteion Hospital, First Department of Neurology, University of Athens, Greece; Clinic for Neurology, Philipps University, Marburg, Germany
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13
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Ocular Motor and Vestibular Disorders in Brainstem Disease. J Clin Neurophysiol 2019; 36:396-404. [PMID: 31688322 DOI: 10.1097/wnp.0000000000000593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
The brainstem contains ocular motor and vestibular structures that, when damaged, produce specific eye movement disorders. In this review, we will discuss three brainstem syndromes with characteristic ocular motor and vestibular findings that can be highly localizing. First, we will discuss the lateral medullary (Wallenberg) syndrome, focusing on ocular lateropulsion, saccadic dysmetria, and the ocular tilt reaction. Second, we will review the medial longitudinal fasciculus syndrome including the ocular tilt reaction, nystagmus, and the vestibular-ocular reflex. Lastly, we will discuss hypertrophic olivary degeneration and oculopalatal tremor, which may develop weeks to months after a brainstem or cerebellar lesion. In these syndromes, the clinical ocular motor and vestibular examination is instrumental in localizing the lesion.
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Peikert K, Gerber J, Winzer S, Schäfer J, Reichmann H, Hermann A. Palatal Tremor with Progressive Ataxia Secondary to A Dural Arteriovenous Fistula. Mov Disord Clin Pract 2019; 6:327-329. [PMID: 31061843 DOI: 10.1002/mdc3.12750] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/23/2019] [Accepted: 02/12/2019] [Indexed: 11/10/2022] Open
Affiliation(s)
- Kevin Peikert
- Department of Neurology University Hospital Carl Gustav Carus, Technische Universität Dresden 01307 Dresden Germany
| | - Johannes Gerber
- Department of Neuroradiology University Hospital Carl Gustav Carus, Technische Universität Dresden 01307 Dresden Germany
| | - Simon Winzer
- Department of Neurology University Hospital Carl Gustav Carus, Technische Universität Dresden 01307 Dresden Germany
| | - Jochen Schäfer
- Department of Neurology University Hospital Carl Gustav Carus, Technische Universität Dresden 01307 Dresden Germany
| | - Heinz Reichmann
- Department of Neurology University Hospital Carl Gustav Carus, Technische Universität Dresden 01307 Dresden Germany
| | - Andreas Hermann
- Department of Neurology University Hospital Carl Gustav Carus, Technische Universität Dresden 01307 Dresden Germany.,German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald 18147 Rostock Germany.,Translational Neurodegeneration Section "Albrecht-Kossel", Department of Neurology, and Center for Transdisciplinary Neurosciences Rostock (CTNR) University Medical Center Rostock, University of Rostock 18147 Rostock Germany
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15
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Rossi M, Cesarini M, Gatto EM, Cammarota A, Merello M. A Treatable Rare Cause of Progressive Ataxia and Palatal Tremor. Tremor Other Hyperkinet Mov (N Y) 2018; 8:538. [PMID: 29971195 PMCID: PMC6026278 DOI: 10.7916/d8x07q2n] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 04/17/2018] [Indexed: 01/14/2023] Open
Abstract
Background Cerebrotendinous xanthomatosis is a rare autosomal recessive neurometabolic disorder characterized by chronic diarrhea, tendon xanthomas, juvenile cataracts, and neurological symptoms. Case Report An adult patient with cerebrotendinous xanthomatosis exhibited ataxia and palatal tremor in the absence of tendon xanthomas and cataracts. Discussion The importance of this case resides on the fact that cerebrotendinous xanthomatosis should be considered as a possible etiology of the syndrome of progressive ataxia with palatal tremor, even in the absence of tendon xanthomas and cataracts. Early diagnosis is critical to the institution of specific treatment with chenodeoxycholic acid.
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Affiliation(s)
- Malco Rossi
- Movement Disorders Section and Neurology Department, Raúl Carrea Institute for Neurological Research (FLENI), Buenos Aires, Argentina
| | - Martin Cesarini
- Movement Disorders Section and Neurology Department, Instituto de Neurociencias de Buenos Aires (INEBA), Buenos Aires, Argentina
| | - Emilia M. Gatto
- Movement Disorders Section and Neurology Department, Instituto de Neurociencias de Buenos Aires (INEBA), Buenos Aires, Argentina
| | - Angel Cammarota
- Movement Disorders Section and Neurology Department, Raúl Carrea Institute for Neurological Research (FLENI), Buenos Aires, Argentina
| | - Marcelo Merello
- Movement Disorders Section and Neurology Department, Raúl Carrea Institute for Neurological Research (FLENI), Buenos Aires, Argentina
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