Neurophysiological study in cerebrotendinous xanthomatosis

Muscle Nerve. 2011 Apr;43(4):531-6. doi: 10.1002/mus.21905.

Abstract

Introduction: Cerebrotendinous xanthomatosis (CTX) is a rare autosomal-recessive disease due to mutations of the 27α-hydroxylase. It is characterized by cataracts, xanthomas, and neurological manifestations. Polyneuropathy has been reported, although it is unclear whether it is axonal or demyelinating.

Methods: We report clinical and neurophysiological results of 13 patients with CTX diagnosed in Spain.

Results: In 8 patients (62%), peripheral neuropathy was demonstrated (4 demyelinating, 3 axonal, and 1 mixed; 3 predominantly motor and 5 sensorimotor). All patients had clinical signs/symptoms of peripheral neuropathy. Upper limb somatosensory evoked potentials (SSEPs) were affected in 38% of patients, and lower limb SSEPs in 67%. Fifty percent of patients had delayed brainstem auditory evoked potentials, and 43% had affected visual evoked potentials.

Discussion: In this series, polyneuropathy was predominantly sensorimotor and demyelinating. Neurophysiological studies correlated only partially with clinical follow-up. Therefore, we recommend neurophysiological follow-up studies only if clinical symptoms are present.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Evoked Potentials, Somatosensory / physiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neural Conduction / physiology*
  • Polyneuropathies / diagnosis
  • Polyneuropathies / epidemiology
  • Polyneuropathies / physiopathology
  • Xanthomatosis, Cerebrotendinous / diagnosis*
  • Xanthomatosis, Cerebrotendinous / epidemiology
  • Xanthomatosis, Cerebrotendinous / physiopathology*
  • Young Adult