Neuromuscular Disorders Neurology in Practice: Series Editors: Robert A
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Mitochondrial Trnaleu(Uur) May Cause an MERRF Syndrome
J7ournal ofNeurology, Neurosurgery, and Psychiatry 1996;61:47-51 47 The A to G transition at nt 3243 of the J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.61.1.47 on 1 July 1996. Downloaded from mitochondrial tRNALeu(uuR) may cause an MERRF syndrome Gian Maria Fabrizi, Elena Cardaioli, Gaetano Salvatore Grieco, Tiziana Cavallaro, Alessandro Malandrini, Letizia Manneschi, Maria Teresa Dotti, Antonio Federico, Giancarlo Guazzi Abstract Two distinct maternally inherited encephalo- Objective-To verify the phenotype to myopathies with ragged red fibres have been genotype correlations of mitochondrial recognised on clinical grounds: MERRF, DNA (mtDNA) related disorders in an which is characterised by myoclonic epilepsy, atypical maternally inherited encephalo- skeletal myopathy, neural deafness, and optic myopathy. atrophy,' and MELAS, which is defined by Methods-Neuroradiological, morpholog- stroke-like episodes in young age, episodic ical, biochemical, and molecular genetic headache and vomiting, seizures, dementia, analyses were performed on the affected lactic acidosis, skeletal myopathy, and short members of a pedigree harbouring the stature.2 Molecular genetic studies later con- heteroplasmic A to G transition at firmed the nosological distinction between the nucleotide 3243 of the mitochondrial two disorders, showing that MERRF is strictly tRNAI-u(UR), which is usually associated associated with two mutations of the mito- with the syndrome of mitochondrial chondrial tRNALYs at nucleotides 83443 and encephalomyopathy, lactic -
Cardiac Manifestations in Emery–Dreifuss Muscular Dystrophy
PRACTICE | CASES CPD Cardiac manifestations in Emery–Dreifuss muscular dystrophy Whitney Faiella MD, Ricardo Bessoudo MD n Cite as: CMAJ 2018 December 3;190:E1414-7. doi: 10.1503/cmaj.180410 35-year-old man with a known history of Emery–Dreifuss muscular dystrophy called emergency medical services KEY POINTS (EMS) while at work one morning, reporting palpitations, • Emery–Dreifuss muscular dystrophy is one of many lightheadedness,A fatigue and a rapid heart rate. On arrival by neuromuscular diseases with cardiac involvement, including EMS, his pulse was documented at 195–200 beats/min, and his bradyarrhythmia, tachyarrhythmia and cardiomyopathy, and rhythm strips showed ventricular tachycardia (Figure 1A). He involves an increased risk of sudden cardiac death. underwent cardioversion and was given a bolus of amiodarone, • A recently published scientific statement highlights key cardiac 150 mg intravenously. In the emergency department and during manifestations in various forms of neuromuscular diseases and includes detailed recommendations regarding screening, admission, his symptoms persisted with rhythm strips showing follow-up and treatment for each individual disease. recurrent episodes of sustained ventricular tachycardia (Fig- • Medical optimization of cardiac function and early detection of ure 1B). He was subsequently started on an amiodarone drip and arrhythmias with subsequent insertion of a pacemaker or oral metoprolol. Echocardiography performed during admission defibrillator can be life-saving in this patient population. showed dilated cardiomyopathy with severe systolic dysfunction and an estimated ejection fraction of 23%. Cardiac catheteriza- tion was performed to rule out an ischemic cause of the cardio- With respect to the patient’s diagnosis of Emery–Dreifuss mus- myopathy and showed normal coronary arteries. -
AMYOTROPHIC LATERAL SCLEROSIS Spin21 (1)
AMYOTROPHIC LATERAL SCLEROSIS Spin21 (1) Amyotrophic Lateral Sclerosis (ALS) Synonyms: CHARCOT'S DISEASE (in Europe), LOU GEHRIG'S DISEASE (in USA) Last updated: April 22, 2019 ETIOPATHOPHYSIOLOGY, PATHOLOGY .................................................................................................. 1 GENETICS ............................................................................................................................................... 3 EPIDEMIOLOGY ........................................................................................................................................ 3 Genetics ............................................................................................................................................ 3 CLINICAL FEATURES ............................................................................................................................... 3 EL ESCORIAL WORLD FEDERATION OF NEUROLOGY CRITERIA .............................................................. 4 CLINICAL COURSE & PROGNOSIS ........................................................................................................... 4 VARIANTS .............................................................................................................................................. 5 DIAGNOSIS................................................................................................................................................ 5 TREATMENT ............................................................................................................................................ -
Multiple Presentation of Mitochondrial Disorders Arch Dis Child: First Published As 10.1136/Adc.81.3.209 on 1 September 1999
Arch Dis Child 1999;81:209–215 209 Multiple presentation of mitochondrial disorders Arch Dis Child: first published as 10.1136/adc.81.3.209 on 1 September 1999. Downloaded from Andreea Nissenkorn, Avraham Zeharia, Dorit Lev, Aviva Fatal-Valevski, Varda Barash, Alisa Gutman, Shaul Harel, Tally Lerman-Sagie Abstract The most severely aVected organs in mito- The aim of this study was to assess the chondrial disorders are those depending on heterogeneous clinical presentations of high rate aerobic metabolism—for example, children with mitochondrial disorders the brain, skeletal and cardiac muscle, the sen- evaluated at a metabolic neurogenetic sory organs, and the kidney.125 We aimed to clinic. The charts of 36 children with describe the great variety of symptomatology in highly suspected mitochondrial disorders patients with mitochondrial disorders in Israel, were reviewed. Thirty one children were and to compare this with the common clinical diagnosed as having a mitochondrial dis- presentations in other countries. order, based on a suggestive clinical pres- entation and at least one of the accepted Patients and methods laboratory criteria; however, in five chil- Thirty six consecutive patients (20 boys and 16 dren with no laboratory criteria the diag- girls) were evaluated at the paediatric neurol- nosis remained probable. All of the ogy clinic, Dana Children’s Hospital from patients had nervous system involvement. August 1994 to August 1996 and at the meta- Twenty seven patients also had dysfunc- bolic neurogenetic clinic, Wolfson Medical tion of other systems: sensory organs in 15 Center from September 1996 to June 1998 for patients, cardiovascular system in five, suspected mitochondrial disorders. -
Treatment of Autonomic Dysreflexia for Adults & Adolescents with Spinal
Treatment of Autonomic Dysreflexia for Adults & Adolescents with Spinal Cord Injuries Authors: Dr James Middleton, Director, State Spinal Cord Injury Service, NSW Agency for Clinical Innovation. Dr Kumaran Ramakrishnan, Honorary Fellow, Rehabilitation Studies Unit, Sydney Medical School Northern, The University of Sydney, and Consultant Rehabilitation Physician & Senior Lecturer, Department of Rehabilitation Medicine, University Malaya. Dr Ian Cameron, Head of the Rehabilitation Studies Unit, Sydney Medical School Northern, The University of Sydney. Reviewed and updated in 2013 by the authors. AGENCY FOR CLINICAL INNOVATION Level 4, Sage Building 67 Albert Avenue Chatswood NSW 2067 PO Box 699 Chatswood NSW 2057 T +61 2 9464 4666 | F +61 2 9464 4728 E [email protected] | www.aci.health.nsw.gov.au Produced by the NSW State Spinal Cord Injury Service. SHPN: (ACI) 140038 ISBN: 978-1-74187-972-8 Further copies of this publication can be obtained from the Agency for Clinical Innovation website at: www.aci.health.nsw.gov.au Disclaimer: Content within this publication was accurate at the time of publication. This work is copyright. It may be reproduced in whole or part for study or training purposes subject to the inclusion of an acknowledgment of the source. It may not be reproduced for commercial usage or sale. Reproduction for purposes other than those indicated above, requires written permission from the Agency for Clinical Innovation. © Agency for Clinical Innovation 2014 Published: February 2014 HS13-136 ACKNOWLEDGEMENTS This document was originally published as a fact sheet for the Rural Spinal Cord Injury Project (RSCIP), a pilot healthcare program for people with a spinal cord injury (SCI) conducted within New South Wales involving the collaboration of Prince Henry & Prince of Wales Hospitals, Royal North Shore Hospital, Royal Rehabilitation Centre Sydney, Spinal Cord Injuries Australia and the Paraplegic & Quadriplegic Association of NSW. -
Open Dogan Phdthesis Final.Pdf
The Pennsylvania State University The Graduate School Eberly College of Science ELUCIDATING BIOLOGICAL FUNCTION OF GENOMIC DNA WITH ROBUST SIGNALS OF BIOCHEMICAL ACTIVITY: INTEGRATIVE GENOME-WIDE STUDIES OF ENHANCERS A Dissertation in Biochemistry, Microbiology and Molecular Biology by Nergiz Dogan © 2014 Nergiz Dogan Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy August 2014 ii The dissertation of Nergiz Dogan was reviewed and approved* by the following: Ross C. Hardison T. Ming Chu Professor of Biochemistry and Molecular Biology Dissertation Advisor Chair of Committee David S. Gilmour Professor of Molecular and Cell Biology Anton Nekrutenko Professor of Biochemistry and Molecular Biology Robert F. Paulson Professor of Veterinary and Biomedical Sciences Philip Reno Assistant Professor of Antropology Scott B. Selleck Professor and Head of the Department of Biochemistry and Molecular Biology *Signatures are on file in the Graduate School iii ABSTRACT Genome-wide measurements of epigenetic features such as histone modifications, occupancy by transcription factors and coactivators provide the opportunity to understand more globally how genes are regulated. While much effort is being put into integrating the marks from various combinations of features, the contribution of each feature to accuracy of enhancer prediction is not known. We began with predictions of 4,915 candidate erythroid enhancers based on genomic occupancy by TAL1, a key hematopoietic transcription factor that is strongly associated with gene induction in erythroid cells. Seventy of these DNA segments occupied by TAL1 (TAL1 OSs) were tested by transient transfections of cultured hematopoietic cells, and 56% of these were active as enhancers. Sixty-six TAL1 OSs were evaluated in transgenic mouse embryos, and 65% of these were active enhancers in various tissues. -
Scienti®C Review Spastic Movement Disorder
Spinal Cord (2000) 38, 389 ± 393 ã 2000 International Medical Society of Paraplegia All rights reserved 1362 ± 4393/00 $15.00 www.nature.com/sc Scienti®c Review Spastic movement disorder V Dietz*,1 1Paracare, Paraplegic Centre of the University Hospital Balgrist, ZuÈrich, Switzerland This review deals with the neuronal mechanisms underlying spastic movement disorder, assessed by electrophysiological means with the aim of ®rst, a better understanding of the underlying pathophysiology and second, the selection of an adequate treatment. For the patient usually one of the ®rst symptoms of a lesion within the central motor system represents the movement disorder, which is most characteristic during locomotion in patients with spasticity. The clinical examination reveals exaggerated tendon tap re¯exes and increased muscle tone typical of the spastic movement disorder. However, today we know that there exists only a weak relationship between the physical signs obtained during the clinical examination in a passive motor condition and the impaired neuronal mechanisms being in operation during an active movement. By the recording and analysis of electrophysiological and biomechanical parameters during a functional movement such as locomotion, the signi®cance of, for example, impaired re¯ex behaviour or pathophysiology of muscle tone and its contribution to the movement disorder can reliably be assessed. Consequently, an adequate treatment should not be restricted to the cosmetic therapy and correction of an isolated clinical parameter but should be based on the pathophysiology and signi®cance of the mechanisms underlying the disorder of functional movement which impairs the patient. Spinal Cord (2000) 38, 389 ± 393 Keywords: spinal cord injury; spasticity; electrophysiological recordings; treatment Introduction Movement disorders are prominent features of impaired strength of electromyographic (EMG) activation of function of the motor systems and are frequently best antagonistic leg muscles as well as intrinsic and passive re¯ected during gait. -
ALS and Other Motor Neuron Diseases Can Represent Diagnostic Challenges
Review Article Address correspondence to Dr Ezgi Tiryaki, Hennepin ALS and Other Motor County Medical Center, Department of Neurology, 701 Park Avenue P5-200, Neuron Diseases Minneapolis, MN 55415, [email protected]. Ezgi Tiryaki, MD; Holli A. Horak, MD, FAAN Relationship Disclosure: Dr Tiryaki’s institution receives support from The ALS Association. Dr Horak’s ABSTRACT institution receives a grant from the Centers for Disease Purpose of Review: This review describes the most common motor neuron disease, Control and Prevention. ALS. It discusses the diagnosis and evaluation of ALS and the current understanding of its Unlabeled Use of pathophysiology, including new genetic underpinnings of the disease. This article also Products/Investigational covers other motor neuron diseases, reviews how to distinguish them from ALS, and Use Disclosure: Drs Tiryaki and Horak discuss discusses their pathophysiology. the unlabeled use of various Recent Findings: In this article, the spectrum of cognitive involvement in ALS, new concepts drugs for the symptomatic about protein synthesis pathology in the etiology of ALS, and new genetic associations will be management of ALS. * 2014, American Academy covered. This concept has changed over the past 3 to 4 years with the discovery of new of Neurology. genes and genetic processes that may trigger the disease. As of 2014, two-thirds of familial ALS and 10% of sporadic ALS can be explained by genetics. TAR DNA binding protein 43 kDa (TDP-43), for instance, has been shown to cause frontotemporal dementia as well as some cases of familial ALS, and is associated with frontotemporal dysfunction in ALS. Summary: The anterior horn cells control all voluntary movement: motor activity, res- piratory, speech, and swallowing functions are dependent upon signals from the anterior horn cells. -
Genetic and Genomic Analysis of Hyperlipidemia, Obesity and Diabetes Using (C57BL/6J × TALLYHO/Jngj) F2 Mice
University of Tennessee, Knoxville TRACE: Tennessee Research and Creative Exchange Nutrition Publications and Other Works Nutrition 12-19-2010 Genetic and genomic analysis of hyperlipidemia, obesity and diabetes using (C57BL/6J × TALLYHO/JngJ) F2 mice Taryn P. Stewart Marshall University Hyoung Y. Kim University of Tennessee - Knoxville, [email protected] Arnold M. Saxton University of Tennessee - Knoxville, [email protected] Jung H. Kim Marshall University Follow this and additional works at: https://trace.tennessee.edu/utk_nutrpubs Part of the Animal Sciences Commons, and the Nutrition Commons Recommended Citation BMC Genomics 2010, 11:713 doi:10.1186/1471-2164-11-713 This Article is brought to you for free and open access by the Nutrition at TRACE: Tennessee Research and Creative Exchange. It has been accepted for inclusion in Nutrition Publications and Other Works by an authorized administrator of TRACE: Tennessee Research and Creative Exchange. For more information, please contact [email protected]. Stewart et al. BMC Genomics 2010, 11:713 http://www.biomedcentral.com/1471-2164/11/713 RESEARCH ARTICLE Open Access Genetic and genomic analysis of hyperlipidemia, obesity and diabetes using (C57BL/6J × TALLYHO/JngJ) F2 mice Taryn P Stewart1, Hyoung Yon Kim2, Arnold M Saxton3, Jung Han Kim1* Abstract Background: Type 2 diabetes (T2D) is the most common form of diabetes in humans and is closely associated with dyslipidemia and obesity that magnifies the mortality and morbidity related to T2D. The genetic contribution to human T2D and related metabolic disorders is evident, and mostly follows polygenic inheritance. The TALLYHO/ JngJ (TH) mice are a polygenic model for T2D characterized by obesity, hyperinsulinemia, impaired glucose uptake and tolerance, hyperlipidemia, and hyperglycemia. -
Neurotoxicity: Identifying and Controlling Poisons of the Nervous System
Index -i abused drugs activities of, 33, 81, 88, 322 addiction, 6, 52,74, 75 aldicarb, 47, 173,251 designer drugs, 51 aldrin, 250,252,292 effects on nervous system, 6,9, 51–53, 71 allyl chloride, 303 health costs of, 20,53,232 aluminum, 48 psychoactive drugs, 6, 10,27,44,50 and Alzheimer’s disease, 54-55 withdrawal from, 74 oxide, 14, 136 see also specific drugs Alzheimer’s disease academic research effects on hippocampus, 71 cooperative agreements with government, 94 environmental cause, 3, 6, 54-55, 70, 72 factors influencing directions of, 92-94 research on, 259 acetaldehyde, 297 American Academy of Pediatrics, 189 acetone, 14, 136,296, 297,303 American Conference of Governmental Industrial Hygienists, acetylcholine, 26, 66, 109, 124,294, 336 28, 151, 185, 186,203,302-303 acetylcholinesterase, 11,50,74,84,187,203, 289,290-292,336 American National Standards Institute, 185 acetylethyl tetramethyl tetralin (AETT) ammonia, 14, 136 exposure route, 108 amphetamines, 74 incidents of poisoning, 47, 54 amyotrophic lateral sclerosis neurological effects of, 54 characteristics of, 54 acrylamide, 73, 120 environmental cause, 3, 6, 54-55, 70, 72 neurotoxicity testing, 166, 175 incidence of, 54, 55 regulation for neurotoxicity, 178 research on, 259 risk assessment approaches, 150, 151,216 anencephaly, 70 research on neurotoxicity, 258 anilines and substituted anilines, 179 acrylates, 175 animal tests, 13 acrylonitrile, 203 accuracy and reliability, 106, 115 neurotoxicity testing, 166, 173 advantages and limitations of, 105, 106, 111, 112, 114, -
Approach to a Patient with Hemiplegia and Monoplegia
CHAPTER Approach to a Patient with Hemiplegia and Monoplegia 27 Sudhir Kumar, Subhash Kaul INTRODUCTION 4. Injury to multiple cervical nerve roots. Monoplegia and hemiplegia are common neurological 5. Functional or psychogenic. symptoms in patients presenting to the emergency department as well as outpatient department. Insidious onset, gradually progressive monoplegia affecting lower limb can be caused by the following Monoplegia refers to weakness of one limb (either arm or conditions: leg) and hemiplegia refers to weakness of one arm and leg on the same side of body (either left or right side). 1. Tumor of the contralateral frontal lobe. There are a variety of underlying causes for monoplegia 2. Tumor of spinal cord at thoracic or lumbar level. and hemiplegia. The causes differ in different age groups. 3. Chronic infection of brain (frontal lobe) or spinal The causes also differ depending on the onset, progression cord (thoracic or lumbar level), such as tuberculous. and duration of weakness. Therefore, one needs to adopt a systematic approach during history taking and 4. Lumbosacral-plexopathy, due to diabetes mellitus. examination in order to arrive at the correct diagnosis. Insidious onset, gradually progressive monoplegia, Appropriate investigations after these would confirm the affecting upper limb, can be caused by one of the following diagnosis. conditions: The aim of this chapter is to systematically look at the 1. Tumor of the contralateral parietal lobe. differential diagnosis of monoplegia and hemiplegia and outline the approach needed to pinpoint the exact 2. Compressive lesion (tumor, large disc, etc) in underlying cause. cervical cord region. 3. Chronic infection of the brain (parietal lobe) or APPROACH TO THE DIAGNOSIS OF MONOPLEGIA spinal cord (cervical region), such as tuberculous. -
Collagen VI-Related Myopathy
Collagen VI-related myopathy Description Collagen VI-related myopathy is a group of disorders that affect skeletal muscles (which are the muscles used for movement) and connective tissue (which provides strength and flexibility to the skin, joints, and other structures throughout the body). Most affected individuals have muscle weakness and joint deformities called contractures that restrict movement of the affected joints and worsen over time. Researchers have described several forms of collagen VI-related myopathy, which range in severity: Bethlem myopathy is the mildest, an intermediate form is moderate in severity, and Ullrich congenital muscular dystrophy is the most severe. People with Bethlem myopathy usually have loose joints (joint laxity) and weak muscle tone (hypotonia) in infancy, but they develop contractures during childhood, typically in their fingers, wrists, elbows, and ankles. Muscle weakness can begin at any age but often appears in childhood to early adulthood. The muscle weakness is slowly progressive, with about two-thirds of affected individuals over age 50 needing walking assistance. Older individuals may develop weakness in respiratory muscles, which can cause breathing problems. Some people with this mild form of collagen VI-related myopathy have skin abnormalities, including small bumps called follicular hyperkeratosis on the arms and legs; soft, velvety skin on the palms of the hands and soles of the feet; and abnormal wound healing that creates shallow scars. The intermediate form of collagen VI-related myopathy is characterized by muscle weakness that begins in infancy. Affected children are able to walk, although walking becomes increasingly difficult starting in early adulthood. They develop contractures in the ankles, elbows, knees, and spine in childhood.