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SENSORY MOTOR NEUROPATHY

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OCULOMOTOR APRAXIA 

ATAXIA TELANGIECTASIA

TELANGIECTASIA OVER EYES AND SUN-EXPOSED AREAS

OCULOMOTOR APRAXIA

HYPOMETRIC SACCADES

DYSTONIA/ CHOREA/ MYOCLONUS

PARKINSONISM/ ATAXIA TREMOR/ NEUROPATHY

LYMPHOMA/ LEUKEMIA (EARLY)

SOLID TUMOUR (LATE)

LAB: LOW IGA/ IGG

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AOA1 (APTX)

AOO 2-10YRS

OCULOMOTOR APRAXIA

DYSTONIA/ CHOREA/ ATAXIA

NEUROPATHY

LAB: ALBUMIN REDUCED

TOTAL CHOLESTEROL INCREASED

NORMAL ALFA FETOPROTEIN

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AOA2 (SETX)

AGE OF ONSET 3-30YRS

OCULOMOTOR APRAXIA

DYSTONIA/ CHOREA/ ATAXIA

NEUROPATHY

LAB: ALBUMIN REDUCED

TOTAL CHOLESTEROL INCREASED

INCREASED IGA/ IGG/ ALPA FETOPROTEIN

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AOA4

DYSPHAGIA

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ANO5

DYSPHAGIA

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NO OCULOMOTOR APRAXIA

CEREBROTENDINOSIS XANTHOMATOSIS

VARIABLE AGE OF PRESENTATION

COGNITIVE DECLINE

ATAXIA/ DYSTONIA/ PARKINSONISM

SPASTICITY/ NEUROPATHY

CATARACTPES CAVUS

XANTHOMAS ACHILLES TENDON

DIARRHOEA

MRI: T2/ FLAIR HYPERINTENSITIES

PERIVENTRICULAR

POSTERIOR LIMB INTERNAL CAPSULE

CEREBRAL PEDUNCLES

ANTERIOR PONS

RX: CHENODEOXYCHOLIC ACID 250MG TID

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SCAN1 

AGE OF ONSET <20YRS

PES CAVUS

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SYNE1 

AGE OF ONSET <40YRS

HYPOTONIA/ CEREBELLAR ATROPHY

MENTAL RETARDATION

CLUB FOOT/ MYOPATHY

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CMT6B

PES CAVUS/ OPTIC ATROPHY 

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SPINOCEREBELLAR ATAXIA

SCA1 (ATXN2 CAG)

OPHTHALMOPLEGIA

SPASTICITY/ SENSORY NEUROPATHY

 

SCA2 (ATXN2 CAG)

OPHTHALMOPLEGIA

SLOW SACCADES

SENSORY NEUROPATHY

 

SCA3 (ATXN3 CAG)

ATAXIA/ PARKINSONISM/DYSTONIA

CPEO/ BULGING EYES

SPASTICITY/ AMYOTROPHY

FACIAL LINGUAL ACTION INDUCED FASCICULATIONS 

 

SCA36 (NOP56 INTRONIC GGCCTG REPEAT)

ATAXIA/ AMYOTROPHY

HEARING LOSS

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OTHERS

FRAGILE X TREMOR ATAXIA SYNDROME (FMR1)

M (1:2500)/ F (1:5000)

PARKINSONISM (85%)

ATAXIA (85%)

TREMOR (90-100%)

COGNITION (50%)

RARELY CHOREA

PSYCHIATRIC MANIFESTATIONS

NEUROPATHY/ AUTONOMIC DYSFUNCTION

FEMALES: MILD AND LATE-ONSET SYMPTOMS

EARLY MENOPAUSE/ IRREGULAR MENSES

MRI: MCP HYPERINTENSITY (LESS IN FEMALES)

CORTICOMEDULLARY JUNCTION

RIBBON LIKE HYPER-INTENSITIES (DWI)

SPLENIUM HYPERINTENSITY (F>M)

CENTRAL PONS HYPERINTENSITY (F>M)

RX: PARKINSONISM RESPONSIVE TO LEVODOPA

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SENSORY NEUROPATHY

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FRIEDREICH'S ATAXIA (FXN) 

ATAXIA/ DYSARTHRIA/  SCOLIOSIS

DIABETES (30%)

HEARING LOSS (20%)

SENSORY GANGLIONOPATHY

HYPERTROPHIC CARDIOMYOPATHY ARRHYTHMIA/ CHF

LATE ONSET FRIEDREICH'S  ATAXIA

(GAA REPEAT X25 GENE)

LOFA 25-40YRS/ VLOFA >40YRS

RETAINED REFLEXES/ SPASTICITY

MRI: CEREBELLAR ATROPHY LATE STAGES

SPINAL CORD ATROPHY

DENTATE IRON ACCUMULATION AND ATROPHY

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ABETALIPOPROTEINAEMIA (MTTP)

DIARRHOEA/ VIT-E/ VIT-D/ VIT-K DEFICIENCY

ATAXIA/ PERIPHERAL NEUROPATHY

RETINITIS PIGMENTOSA/ CPEO

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ATAXIA WITH VITAMIN E DEFICIENCY (TTPA)

VIT-E DEFICIENCY

TITUBATION

ATAXIA/ PERIPHERAL NEUROPATHY

RETINITIS PIGMENTOSA/ MACULAR ATROPHY

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CANVAS (RFC1-AAGGG)  

AGE OF ONSET <50YRS

CEREBELLAR/ VESTIBULAR/ SENSORY ATAXIA

ABNORMAL VVOR AND PURSUIT

ABNORMAL VVOR : 

HEAD MOVED AT 0.5HZ WITH VISION FIXED AT EARTH FIXED TARGET. SACCADIC EYE MOVEMENTS SEEN AS VESTIBULAR AND PURSUIT BOTH ARE ABNORMAL

SENSORY MOTOR NEUROROPATHY 

GANGLIONOPATHY

COUGH/AUTONOMIC DYSFUNCTION

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CELIAC DISEASE

ATAXIA/ LEG MYOCLONUS

NEUROPATHY/ DIARRHOEA

GOBBI SYNDROME: CEC SYNDROME

CELIAC DISEASE/ SEIZURES/ OCCIPITAL CALCIFICATION

MRI: BILATERAL OCCIPITAL CALCIFICATIONS

LAB: ANTI TTG ANTIBODIES

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FAHR SYNDROME

PARKINSONISM

NEUROPSYCHIATRIC FEATURES

SEIZURES/ CHOREA

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DORSAL ROOT GANGLIA

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CELIAC DISEASE

ATAXIA/ LEG MYOCLONUS

NEUROPATHY/ DIARRHOEA

GOBBI SYNDROME: CEC SYNDROME

CELIAC DISEASE/ SEIZURES/ BILATERAL

MRI: OCCIPITAL CALCIFICATIONS

LAB: ANTI TTG ANTIBODIES

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FRIEDREICH'S ATAXIA (FXN) 

ATAXIA/ DYSARTHRIA/  SCOLIOSIS

DIABETES (30%)

HEARING LOSS (20%)

SENSORY GANGLIONOPATHY

HYPERTROPHIC CARDIOMYOPATHY ARRHYTHMIA/ CHF

LATE ONSET FRIEDREICH'S  ATAXIA

(GAA REPEAT X25 GENE)

LOFA 25-40YRS/ VLOFA >40YRS

RETAINED REFLEXES/ SPASTICITY

MRI: CEREBELLAR ATROPHY LATE STAGES

SPINAL CORD ATROPHY

DENTATE IRON ACCUMULATION AND ATROPHY

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SJOGREN

DRY EYES/ DRY MOUTH

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PYRIDOXINE (VIT B6) TOXICITY

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PARANEOPLASTIC

ANTI- HU AB

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HIV INFECTION

POLG1 (NUCLEAR DNA)

MIRAS (POLG1) 

CHILDHOOD: ENCEPHALOPATHY

JUVENILE: EPILEPSY/ MIGRAINE

ADULT ONSET: ATAXIA NEUROPATHY

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SANDOS (POLG1)

SENSORY ATAXIA/ DYSARTHRIA/ OPHTHALMOPLEGIA

PARKINSONISM

COMPOUND  HETEROZYGOUS MUTATION CAN HAVE LATE PRESENTATION, 80YRS

 

MEMSA (POLG1)

MYOCLONIC EPILEPSY/ MYOPATHY 

SENSORY ATAXIA

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MINGIE (POLG1)

MITOCHONDRIAL NEUROGASTROINTESTINAL ENCEPHALOPATHY

GASTROPARESIS/ ATAXIA

NEUROPATHY/ MYOPATHY

LEUKOENCEPHALOPATHY

OPTHALMOPARESIS/ PTOSIS

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SCAE (POLG1)

OLD TERMINOLOGY

NOW INCLUDES MEMSA

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MITOCHONDRIAL DNA

LEIGH SYNDROME

MITOCHONDRIAL/ NUCLEAR GENES INVOLVED IN OXIDATIVE PHOSPHORYLATION (COMPLEX 1-4)

COGNITION/ ATAXIA/CHOREA

OPTIC ATROPHY/ RETINITIS PIGMENTOSA

STRABISMUS/ OPHTHALMOPARESIS

NEUROPATHY/ MYOPATHY

SHORT STATURE/ CARDIOMYOPATHY

ADULT ONSET SUBACUTE NECROTIZING ENCEPHALOPATHY

VISION PROBLEM/ ATAXIA

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KEARNS SAYRE SYNDROME

AGE OF ONSET <20YRS

RETINITIS PIGMENTOSA/ OPTIC ATROPHY

ATAXIA NEUROPATHY

SHORT STATURE/ DEAFNESS

DIABETES/ HYPOTHYROIDISM

LAB: CONDUCTION BLOCK/ CSF PROTEIN INCREASED

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MERRF

MYOCLONUS/ GTCS

ATAXIA/ NEUROPATHY/ MYOPATHY

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NARP (MT-ATP6)

NEUROPATHY/ ATAXIA

RETINITIS PIGMENTOSA

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COQ10 DEF (APTX/ADCK3)

HYPOGONADISM/SEIZURES

PES CAVUS/ MYOPATHY

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COQ8A ATAXIA 

EPILEPSY/COGNITION

DYSTONIA/ MYOCLONUS

CEREBELLAR ATROPHY

LARGEST SERIES 58 PTS

MRI: DENTATE/ PONTINE HYPER

RX: COQ10

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ATAXIA-MND

 

SYNE1

AGE OF ONSET <40YRS

ALS PHENOTYPE (20%)

PURE UMN(30%)

PURE LMN(10%)

STRABISMUS (ESOTROPIA)

SQUARE WAVE JERKS

OPHTHALMOPARESIS

QUEBEC: FA > ARSACS > SYNE1

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GM2 TAY SACHS

ATAXIA, MND, SPASTICITY

STIMULUS SENSITIVE MYOCLONUS

CHERRY RED SPOT FUNDUS

CAN PRESENT IN LATE ADULTHOOD

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ANO10

TORTUOUS CONJUNCTIVAL VESSELS

COGNITIVE DECLINE

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DEMYELINATING NEUROPATHY 

 

REFSUM (PHYN/PEX7)  

ATAXIA/ DEAFNESS/ ANOSMIA

RETINITIS PIGMENTOSA

ICHTHIOSIS/ SENSORY NEUROPATHY

DEMYELINATING NEUROPATHY

PLASMA PHYTANIC ACID LEVELS RAISED

RX: AVOID PHYTANIC ACID

HIGH CALORIC DIET: PREVENT MOBILIZATION OF PHYTANIC ACID FOR ADIPOSE TISSUE

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PHARC SYNDROME (ABHD12)

POLYNEUROPATHY (DEMYELINATING)

HEARING LOSS/ ATAXIA 

RETINITIS PIGMENTOSA/ CATARACT

PES CAVUS

REFSUM PHENOTYPE

LAB: PHYTANIC ACID LEVELS NORMAL

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SCP2 MUTATIONS 

FOCAL OMD/ TORTICOLLIS

ATAXIA/ DYSTONIA/ MOTOR NEUROPATHY

MRI: CEREBRAL/ PONS WHITE MATTER HYPERINTENSITY

BASAL GANGLIA IRON DEPOSITION

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ARSACS (SACS)  

RETINAL NERVE FIBER AND GANGLION  LAYER THICKENING

PERIPAPILLARY RETINAL STRIATIONS

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METACHROMATIC LEUKODYSTROPHY (ARSA/ PSAP)

DEMYELINATING PERIPHERAL NEUROPATHY 

HYPER-REFLEXIA

ATAXIA/ SPASTICITY/ COGNITION

MRI: PERIVENTRICULAR WMH/ TIGROID PATTERN

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KRABBE (GALC)

DEMYELINATING PERIPHERAL NEUROPATHY 

ATAXIA/ SPASTICITY/ COGNITION

MRI: CST/ MCP HYPERINTENSITIES

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ADRENOMYELONEUROPATHY

MOST COMMON PHENOTYPE OF  ALD

SPASTICITY/ VIBRATION LOSS 

PERIPHERAL NEUROPATHY

PREDOMINANTLY AXONAL

CAN BE DEMYELINATING

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CEREBROTENDINOSIS XANTHOMATOSIS

VARIABLE AGE OF PRESENTATION

COGNITIVE DECLINE

ATAXIA/ DYSTONIA/ PARKINSONSIM

SPASTICITY/ NEUROPATHY/ PES CAVUS

CATARACTDIARRHOEA

MRI: POSTERIOR LIMB INTERNAL CAPSULE

CEREBRAL PEDUNCLES

ANTERIOR PONS HYPERINTENSITY

RX: CHENODEOXYCHOLIC ACID 250MG TID

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CMT4

CHILDHOOD

FRIEDREICH ATAXIA PHENOTYPE

ATAXIA/ DEMYELINATING POLYNEUROPATHY

THICKENED CRANIAL NERVES (5TH CN)

MYOKYMIA/ PES CAVUS/ SCOLIOSIS

HEARING LOSS (10%)

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