Should we investigate mitochondrial disorders in progressive adult-onset undetermined ataxias?

Slowly Progressive Cerebellar Ataxia in a 55-Year-Old Female Patient

A 55-year-old female patient with a history of hypercholesterolemia and anxiety presented for imbalance, fear of falling, and progressive disability. Examination revealed gaze-evoked horizontal nystagmus, ataxic dysarthria, sensory neuronopathy, and cerebellar atrophy. What is your diagnosis?

Ramsay Hunt syndrome: New impressions in the era of molecular genetics

More frequent use of next-generation sequencing led to a paradigm shift in assessing heredodegenerative diseases. This is particularly notable in progressive myoclonus epilepsy (PME) and progressive myoclonus ataxia (PMA) where a group of disorders linked to novel genetic mutations has now been added to these phenotypical realms. Despite the historical value of Ramsay Hunt's contribution defining the syndrome later known as PMA, recent genetic developments have made this eponym obsolete and a new definition and classification of PMA and PME seem necessary. A rational possibility is to adopt the wider term progressive myoclonus ataxia and epilepsy syndrome (PMAES), which can be subdivided into its main subtypes, PME and PMA, whenever clinical data is sufficient to make that distinction.