Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042571 (vertigo)
 7,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spinocerebellar ataxia type 6 (SCA6) is genetically defined as a group of SCA characterized by late-onset pure cerebellar ataxia clinically and by a small CAG repeat expansion in the gene encoding the alpha 1A-voltage-dependent-Ca channel subunit (CACNL1A4) on chromosome 19p13.1 genetically. We analyzed the initial symptoms and the mode of progression in this disorder on 25 genetically verified patients. The initial symptoms were recurrent episodes of transient vertigo (72%) or unsteady gait (28%). Neurologically, they showed apparent gaze-evoked nystagmus (92%), transient positional nystagmus (83%), and periodic alternating nystagmus (4%), in addition to cerebellar ataxia. In addition to these episodic symptoms, all patients developed progressive cerebellar ataxia over years. These fluctuating symptoms at the initial stage of the illness were clearly different from those of other SCA, rather overlapping with those of episodic ataxia type 2 (EA2), an allelic disorder of SCA6. The clinical similarity indicates that there might be a common mechanism at least in part causing these two disorders. The mode of progression and their neurological features were also presented.
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PMID:[Initial symptoms and mode of neurological progression in spinocerebellar ataxia type 6 (SCA6)]. 984 64

Spinocerebellar ataxia type 6 (SCA6), episodic ataxia type 2 (EA2) and familial hemiplegic migraine (FHM) have been known as allelic disorders, which are caused by the alteration of the alpha1A voltage-dependent calcium channel subunit. Expansions of the CAG repeat in the CACNA1A gene on the short arm of the chromosome 19 induce SCA6, and point mutations in the same gene are responsible for EA2 and FHM. In recent studies, both SCA6 and EA2 have been concurrently found in families with 26 CAG repeats without previously reported point mutations either in coding sequences or in intron-exon junctions. We describe a Korean family with CAG26 repeats in the CACNA1A gene. Some of the affected family members had progressive ataxia typical of SCA6 whereas others had episodic vertigo responsive to acetazolamide typical of EA2. Our family support that SCA6 and EA2 are allelic disorders with a high phenotypic variability.
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PMID:Spinocerebellar ataxia type 6 and episodic ataxia type 2 in a Korean family. 1174 69

Spinocerebellar ataxia (SCA) is a group of heterogeneous disorders. In Japan, approximately 60% of SCA consist of sporadic disorders, and the rest mostly consists of a variety of late-onset dominant disorders. In the latter, MJD, SCA6, DRPLA, SCA1 and SCA2 are frequent in this order, and others are rare. All these disorders are caused by unstable expansion of CAG repeat in the coding region of each responsible gene. Among those disorders, SCA6 manifests late-onset pure cerebellar ataxia and frequently associated with positioning vertigo. In other disorders, phenotype variation, clinical severity, and onset of age are known to correlate inversely with the CAG repeat size. Such variation even in a given disorder is often difficult to apply single criteria to diagnose the disorder based on its clinical findings alone. MSA is a major disorder of sporadic SCA. Signs of cerebellar ataxia, parkinsonism, autonomic disturbance are incorporated into current diagnostic criteria. However, cases meeting the criteria of autonomic disturbances are confined to the advanced stage of the illness or rare cases starting with obvious dysautonomia. These problems indicate that the criteria need further adjustment.
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PMID:[Differential diagnosis of spinocerebellar ataxia]. 1278 68

Spinocerebellar ataxia type 6 (SCA6) is a calcium channelopathy due to a pathological CAG repeat expansion in CACNL1A4. Patients frequently describe paroxysmal vertigo early in the disease course, but it is not clear whether this is central or labyrinthine in origin. To address this issue we studied 21 SCA6 patients. Symptoms of vertigo were defined using a structured questionnaire. Signs were recorded during a standardised bed-side vestibular examination that included systematic positional testing with Frenzel goggles.Brief, recurrent attacks of vertigo occurred in 13 patients, usually preceding the onset of ataxia. Nystagmus was observed behind Frenzel goggles in 14 patients, and was induced either during positional testing, or head shaking in 20 patients. Only one patient had findings typical of benign paroxysmal positional vertigo (BPPV). Combined downbeat and horizontal gaze-evoked nystagmus ("side-pocket") was the most common form, occurring most commonly in supine and head-hanging positions, and following horizontal head-shaking. Nystagmus beating away from the ground (apogeotropic) occurred in 9 patients as they lay on their side.In conclusion, vertigo and abnormalities on bedside vestibular examination are common in SCA6, with forms of nystagmus typical of cerebellar, rather than labyrinthine, disease. These findings demonstrate phenotypic overlap between SCA6 and episodic ataxia type 2, which are both due to mutations in CACNL1A4.
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PMID:Vertigo and vestibular abnormalities in spinocerebellar ataxia type 6. 1922 13