Untangling the Thorns: Advances in the Neuroacanthocytosis Syndromes

There have been significant advances in neuroacanthocytosis (NA) syndromes in the past 20 years, however, confusion still exists regarding the precise nature of these disorders and the correct nomenclature. This article seeks to clarify these issues and to summarise the recent literature in the fiel...

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Main Author: Ruth H. Walker
Format: Article
Language:English
Published: Korean Movement Disorder Society 2015-05-01
Series:Journal of Movement Disorders
Subjects:
Online Access:http://e-jmd.org/upload/jmd-8-2-41.pdf
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author Ruth H. Walker
author_facet Ruth H. Walker
author_sort Ruth H. Walker
collection DOAJ
description There have been significant advances in neuroacanthocytosis (NA) syndromes in the past 20 years, however, confusion still exists regarding the precise nature of these disorders and the correct nomenclature. This article seeks to clarify these issues and to summarise the recent literature in the field. The four key NA syndromes are described here–chorea-acanthocytosis, McLeod syndrome, Huntington’s disease-like 2, and pantothenate kinase- associated neurodegeneration. In the first two, acanthocytosis is a frequent, although not invariable, finding; in the second two, it occurs in approximately 10% of patients. Degeneration affecting the basal ganglia is the key neuropathologic finding, thus the clinical presentations can be remarkably similar. The characteristic phenotype comprises a variety of movement disorders, including chorea, dystonia, and parkinsonism, and also psychiatric and cognitive symptoms attributable to basal ganglia dysfunction. The age of onset, inheritance patterns, and ethnic background differ in each condition, providing diagnostic clues. Other investigations, including routine blood testing and neuroimaging can be informative. Genetic diagnosis, if available, provides a definitive diagnosis, and is important for genetic counseling, and hopefully molecular therapies in the future. In this article I provide a historical perspective on each NA syndrome. The first 3 disorders, chorea-acanthocytosis, McLeod syndrome, Huntington’s disease-like 2, are discussed in detail, with a comprehensive review of the literature to date for each, while pantothenate kinase-associated neurodegeneration is presented in summary, as this disorder has recently been reviewed in this journal. Therapy for all of these diseases is, at present, purely symptomatic.
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spelling doaj.art-a2e31a576139482d959be310b42665172023-08-02T07:55:39ZengKorean Movement Disorder SocietyJournal of Movement Disorders2005-940X2093-49392015-05-0182415410.14802/jmd.15009129Untangling the Thorns: Advances in the Neuroacanthocytosis SyndromesRuth H. Walker0 Department of Neurology, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USAThere have been significant advances in neuroacanthocytosis (NA) syndromes in the past 20 years, however, confusion still exists regarding the precise nature of these disorders and the correct nomenclature. This article seeks to clarify these issues and to summarise the recent literature in the field. The four key NA syndromes are described here–chorea-acanthocytosis, McLeod syndrome, Huntington’s disease-like 2, and pantothenate kinase- associated neurodegeneration. In the first two, acanthocytosis is a frequent, although not invariable, finding; in the second two, it occurs in approximately 10% of patients. Degeneration affecting the basal ganglia is the key neuropathologic finding, thus the clinical presentations can be remarkably similar. The characteristic phenotype comprises a variety of movement disorders, including chorea, dystonia, and parkinsonism, and also psychiatric and cognitive symptoms attributable to basal ganglia dysfunction. The age of onset, inheritance patterns, and ethnic background differ in each condition, providing diagnostic clues. Other investigations, including routine blood testing and neuroimaging can be informative. Genetic diagnosis, if available, provides a definitive diagnosis, and is important for genetic counseling, and hopefully molecular therapies in the future. In this article I provide a historical perspective on each NA syndrome. The first 3 disorders, chorea-acanthocytosis, McLeod syndrome, Huntington’s disease-like 2, are discussed in detail, with a comprehensive review of the literature to date for each, while pantothenate kinase-associated neurodegeneration is presented in summary, as this disorder has recently been reviewed in this journal. Therapy for all of these diseases is, at present, purely symptomatic.http://e-jmd.org/upload/jmd-8-2-41.pdfNeuroacanthocytosisChoreaChorea-acanthocytosisMcLeod syndromeAcanthocytesHuntington’s disease-like 2
spellingShingle Ruth H. Walker
Untangling the Thorns: Advances in the Neuroacanthocytosis Syndromes
Journal of Movement Disorders
Neuroacanthocytosis
Chorea
Chorea-acanthocytosis
McLeod syndrome
Acanthocytes
Huntington’s disease-like 2
title Untangling the Thorns: Advances in the Neuroacanthocytosis Syndromes
title_full Untangling the Thorns: Advances in the Neuroacanthocytosis Syndromes
title_fullStr Untangling the Thorns: Advances in the Neuroacanthocytosis Syndromes
title_full_unstemmed Untangling the Thorns: Advances in the Neuroacanthocytosis Syndromes
title_short Untangling the Thorns: Advances in the Neuroacanthocytosis Syndromes
title_sort untangling the thorns advances in the neuroacanthocytosis syndromes
topic Neuroacanthocytosis
Chorea
Chorea-acanthocytosis
McLeod syndrome
Acanthocytes
Huntington’s disease-like 2
url http://e-jmd.org/upload/jmd-8-2-41.pdf
work_keys_str_mv AT ruthhwalker untanglingthethornsadvancesintheneuroacanthocytosissyndromes