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Abstract
RATIONALE Cerebral cavernous malformation (CCM) of the familial type is caused by abnormalities in the CCM1, CCM2, and CCM3 genes. These 3 proteins forming a complex associate with the maintenance of vascular endothelial cell-cell junctions. Dysfunction of these proteins results in the development of hemangiomas and abnormal intercellular junctions. PATIENT CONCERNS We report a 68-year-old man with familial cerebral cavernous malformation with initial presentation as convulsions at an advanced age. Brain magnetic resonance imaging revealed multiple cavernous hemangiomas in the right occipital lobe. The convulsions were considered to be induced by hemorrhage from cavernous hemangioma in the right occipital lobe. DIAGNOSES Genetic screening of the CCM1, CCM2, and CCM3 genes revealed a novel mutation in the CCM2 gene (exon4 c: 359 T>A, p: V120D). No abnormalities were found in CCM1 or CCM3. Therefore, we diagnosed the patient with familial CCM caused by a CCM2 mutation. INTERVENTIONS This patient was treated with the administration of levetiracetam at a dosage of 1000 mg/day. OUTCOMES No seizures have been observed since the antiepileptic drug was administered. We performed brain magnetic resonance imaging (MRI) regularly to follow-up on appearance of new cerebral hemorrhages and cavernous hemangiomas. LESSONS This report reviews cases of familial cerebral cavernous malformations caused by abnormalities in the CCM2 gene. This mutation site mediates interactions with CCM1 and CCM3. The mutation occurs in the phosphotyrosine binding (PTB) site, which is considered functionally important to CCM2.
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MESH Headings
- Aged
- Anticonvulsants/administration & dosage
- Anticonvulsants/therapeutic use
- Carrier Proteins/genetics
- Genetic Testing
- Hemangioma, Cavernous/complications
- Hemangioma, Cavernous/genetics
- Hemangioma, Cavernous/pathology
- Hemangioma, Cavernous, Central Nervous System/diagnostic imaging
- Hemangioma, Cavernous, Central Nervous System/drug therapy
- Hemangioma, Cavernous, Central Nervous System/genetics
- Hemangioma, Cavernous, Central Nervous System/pathology
- Hemorrhage/diagnostic imaging
- Hemorrhage/etiology
- Humans
- Levetiracetam/administration & dosage
- Levetiracetam/therapeutic use
- Magnetic Resonance Imaging/methods
- Male
- Mutation
- Seizures/diagnosis
- Seizures/etiology
- Treatment Outcome
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Affiliation(s)
- Kazuhiro Ishii
- Department of Neurology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennnoudai, Tsukuba, Ibaraki, 305-8575
| | - Naoki Tozaka
- Department of Neurology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennnoudai, Tsukuba, Ibaraki, 305-8575
| | - Satoshi Tsutsumi
- Department of Neurological Surgery, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba 279-0021
| | - Ai Muroi
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennnoudai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Akira Tamaoka
- Department of Neurology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennnoudai, Tsukuba, Ibaraki, 305-8575
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Hosaka T, Nakamagoe K, Tozaka N, Aizawa S, Tamaoka A. Steroid pulse therapy of radiological disease activity without clinical relapse in CLIPPERS. Neurol Sci 2020; 41:709-711. [PMID: 31482246 DOI: 10.1007/s10072-019-04064-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 08/29/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Takashi Hosaka
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Kiyotaka Nakamagoe
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan.
| | - Naoki Tozaka
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Satoshi Aizawa
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
| | - Akira Tamaoka
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, 305-8575, Japan
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Abstract
Familial Mediterranean fever (FMF) is an autoinflammatory disease characterized by a recurrent fever and multiple serositis. In the present report, we discuss the case of a 42-year-old man diagnosed with FMF accompanied by recurrent aseptic meningitis (RAM). The patient experienced RAM at intervals of several years without any serositis or synovitis. We detected Mediterranean fever (MEFV) gene mutations (E148Q homozygotes) and diagnosed FMF in perfect accordance with clinical diagnostic criteria. FMF, in which RAM is a major symptom, has also been described in previous reports. Therefore, FMF should be considered in the differential diagnosis of causative diseases for RAM.
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Affiliation(s)
- Takahiro Hosoi
- Department of General Medicine, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Kazuhiro Ishii
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Naoki Tozaka
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Dai Kishida
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Japan
| | - Yoshiki Sekijima
- Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Japan
| | - Akira Tamaoka
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Japan
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Nohara S, Ishii A, Yamamoto F, Yanagiha K, Moriyama T, Tozaka N, Miyake Z, Yatsuga S, Koga Y, Hosaka T, Terada M, Yamaguchi T, Aizawa S, Mamada N, Tsuji H, Tomidokoro Y, Nakamagoe K, Ishii K, Watanabe M, Tamaoka A. GDF-15, a mitochondrial disease biomarker, is associated with the severity of multiple sclerosis. J Neurol Sci 2019; 405:116429. [PMID: 31476622 DOI: 10.1016/j.jns.2019.116429] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 08/14/2019] [Accepted: 08/14/2019] [Indexed: 01/08/2023]
Abstract
GDF-15, a member of the transforming growth factor beta superfamily, regulates inflammatory and apoptotic pathways in various diseases, such as heart failure, kidney dysfunction, and cancer. We aimed to clarify potentially confounding variables affecting GDF-15 and demonstrate its utility as a mitochondrial biomarker using serum samples from 15 patients with mitochondrial diseases (MD), 15 patients with limbic encephalitis (LE), 10 patients with multiple sclerosis/neuromyelitis optica spectrum disorders (MS/NMOSD), and 19 patients with amyotrophic lateral sclerosis (ALS). GDF-15 and FGF-21 were significantly elevated in MD. GDF-15 and FGF-21 showed a good correlation in MD but not in LE, MS, and ALS. GDF-15 was potentially influenced by age in LE, MS/NMOSD, and ALS but not in MD. FGF-21 was not correlated with age in MS/NMOSD, ALS, LE, and MD. GDF-15 was not correlated with clinical features in LE or BMI or body weight in ALS. GDF-15 positively correlated with the Expanded Disability Status Scale (EDSS) in MS/NMOSD, while EDSS showed no correlation with age. In conclusion, the results revealed that GDF-15 may be influenced by EDSS in MS/NMOPSD and by age in LE, MS/NMOSD, and ALS but not in MD. Mitochondrial damage in MS/NMOSD is a potentially confounding variable affecting GDF-15.
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Affiliation(s)
| | - Akiko Ishii
- Department of Neurology, University of Tsukuba, Japan.
| | | | - Kumi Yanagiha
- Department of Neurology, University of Tsukuba, Japan
| | | | - Naoki Tozaka
- Department of Neurology, University of Tsukuba, Japan
| | - Zenshi Miyake
- Department of Neurology, University of Tsukuba, Japan
| | - Shuichi Yatsuga
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Japan
| | - Yasutoshi Koga
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Japan
| | | | - Makoto Terada
- Department of Neurology, University of Tsukuba, Japan
| | | | | | - Naomi Mamada
- Department of Neurology, University of Tsukuba, Japan
| | - Hiroshi Tsuji
- Department of Neurology, University of Tsukuba, Japan
| | | | | | | | | | - Akira Tamaoka
- Department of Neurology, University of Tsukuba, Japan
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Okune S, Ishii A, Tozaka N, Shioya A, Tamaoka A. Late onset form of lipid storage myopathy; 2 case reports. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Takeda H, Ishii A, Nohara S, Tozaka N, Miyake Z, Okune S, Tsuji H, Tomidokoro Y, Nakamagoe K, Watanabe M, Ishii K, Tamaoka A. Lambert-Eaton myasthenic syndrome; Report of two cases. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ishii A, Ishii A, Nohara S, Yanagiha K, Moriyama T, Tozaka N, Miyake Z, Okune S, Tsuji H, Tomidokoro Y, Nakamagoe K, Ishii K, Watanabe M, Tamaoka A, Yatsuga S, Koga Y. GDF-15 expression in multiple sclerosis and limbic encephalitis. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Shimizu M, Tozaka N, Ishii A, Mamada N, Terada M, Takuma H, Tamaoka A. Third nerve palsy due to local inflammation associated with vascular compression: A case series. J Neurol Sci 2016; 367:365-7. [DOI: 10.1016/j.jns.2016.06.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 06/19/2016] [Accepted: 06/22/2016] [Indexed: 12/15/2022]
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Nakamagoe K, Kadono K, Koganezawa T, Takiguchi M, Terada M, Yamamoto F, Moriyama T, Yanagiha K, Nohara S, Tozaka N, Miyake Z, Aizawa S, Furusho K, Tamaoka A. Vestibular Impairment in Frontotemporal Dementia Syndrome. Dement Geriatr Cogn Dis Extra 2016; 6:194-204. [PMID: 27350780 PMCID: PMC4913767 DOI: 10.1159/000445870] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background No studies to date have attempted to evaluate frontotemporal lobar degeneration from the perspective of the vestibular system. Objective The present study examined vestibular function in patients with frontotemporal dementia (FTD) clinical syndrome and evaluated whether vestibular disorders are involved in the clinical symptoms due to FTD. Methods Fourteen patients with FTD syndrome, as well as healthy elderly controls without dementia, were included in the present study. All subjects underwent vestibular function tests using electronystagmography, such as caloric tests and visual suppression (VS) tests, in which the induced caloric nystagmus was suppressed by visual stimuli. The association between clinical symptoms and vestibular function in the FTD syndrome group was further examined. Results In the FTD syndrome group, caloric nystagmus was not necessarily suppressed during VS tests. Furthermore, VS was observed to be significantly impaired in FTD syndrome patients with gait disturbance as compared to those without such disturbance. Conclusion The present study revealed that impairment of VS in patients with FTD results in an inability to regulate vestibular function by means of visual perception, regardless of multiple presumed neuropathological backgrounds. This could also be associated with gait disturbance in patients with FTD syndrome.
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Affiliation(s)
- Kiyotaka Nakamagoe
- Department of Neurology, Division of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kotarou Kadono
- Department of Neurology, Division of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tadachika Koganezawa
- Department of Physiology, Division of Biomedical Science, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Mao Takiguchi
- Department of Neurology, Division of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Makoto Terada
- Department of Neurology, Division of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Fumiko Yamamoto
- Department of Neurology, Division of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tetsuya Moriyama
- Department of Neurology, Division of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kumi Yanagiha
- Department of Neurology, Division of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Seitaro Nohara
- Department of Neurology, Division of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Naoki Tozaka
- Department of Neurology, Division of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Zenshi Miyake
- Department of Neurology, Division of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Satoshi Aizawa
- Department of Neurology, Division of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kentaro Furusho
- Department of Neurology, Ryugasaki Saiseikai Hospital, Ryugasaki, Japan
| | - Akira Tamaoka
- Department of Neurology, Division of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
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