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Atypical presentation of ataxia–oculomotor apraxia type 1

Published online by Cambridge University Press:  15 May 2006

Amre Shahwan
Affiliation:
Neurology Department, Royal Children's Hospital, Melbourne, Australia.
Philip J Byrd
Affiliation:
CR-UK Institute for Cancer Studies, University of Birmingham, UK.
A Malcolm R Taylor
Affiliation:
CR-UK Institute for Cancer Studies, University of Birmingham, UK.
Therese Nestor
Affiliation:
Department of Paediatric Neurology, The Children's University Hospital, Dublin, Ireland.
Stephanie Ryan
Affiliation:
Department of Paediatric Radiology, The Children's University Hospital, Dublin, Ireland.
Mary D King
Affiliation:
Department of Paediatric Neurology, The Children's University Hospital, Dublin, Ireland.
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Abstract

A subgroup of autosomal recessive cerebellar ataxias (ARCAs) associated with oculomotor apraxia (OMA) and other variable features has been reported. Ataxia–oculomotor apraxia types 1 and 2 (AOA1 and AOA2) belong to this subgroup and have been described in adults with early onset cerebellar ataxia. AOA1 is associated with oculomotor apraxia, severe sensorimotor neuropathy, choreiform movements, cognitive impairment, and cerebellar atrophy at an early age. We describe a male child with AOA1 who is homozygous for the G837A (W279X) mutation in the APTX gene. He presented at the age of 3 years 6 months with some atypical features including absence of OMA, chorea, and cerebellar atrophy. These manifestations, in addition to peripheral neuropathy, appeared at 8 years of age. We highlight the importance of considering the diagnosis of AOA1 in children with early-onset cerebellar ataxia, once other well-known disorders such as Friedreich's ataxia and ataxia–telangiectasia have been excluded.

Type
Case Report
Copyright
2006 Mac Keith Press

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