Childhood neuronal ceroid-lipofuscinoses in Argentina

Am J Med Genet. 1995 Jun 5;57(2):144-9. doi: 10.1002/ajmg.1320570207.

Abstract

We report on 30 cases of neuronal ceroid lipofuscinoses (NCL), mainly diagnosed in 1985-1993 in Argentina, whose population is predominantly of European descent. Twenty-four cases were late infantile Jansky-Bielschowsky (LINCL) and 6 were juvenile Spielmeyer-Vogt (JNCL). Sex ratio was female:male, 20:10. Age range and mean at onset and at diagnosis for the LINCL cases were 1-6 years, mean 3.1, and 2-11 years, mean 5.5, and for the JNCL cases, 5-9 years, mean 7, and 9-18 years, mean 13, respectively. Cases were referred for biopsy after neurological examination, and most included complete electrophysiological [electroencephalography (EEG) with photic stimulation, electroretinography (ERG), and visual-evoked potential (VEP)], neuroimaging, and neurometabolic investigation. NCL was the first suspected clinical diagnosis, followed by mitochondrial encephalopathy in some cases of recent onset. Except for 1 case, clinical findings were homogeneous in LINCL, characterized by refractive epilepsy, mental regression and progressive deterioration, ataxia, myoclonia, and visual loss. Abnormal VEP, ERG, and EEG, with polyphasic high-voltage spikes when photic stimulation was performed at low frequency, were observed. Visual impairment and retinitis pigmentosa were early manifestations in 4/6 JNCL, followed by mental abnormalities, motor deterioration, and myoclonic jerks, while 2/4 followed an atypical course. In both variants inheritance was autosomal-recessive. Five out of 27 families had more than 1 affected member, 3 of whom were included in our series. Diagnosis was initially performed in conjunctival biopsy in 3 cases, skin in 5, muscle in 17, and brain in 5, though most cases had a concomitant biopsy from another tissue including nerve, and there was a single brain autopsy.(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Age Factors
  • Age of Onset
  • Argentina / epidemiology
  • Autopsy
  • Biopsy
  • Brain / pathology
  • Brain / ultrastructure
  • Child
  • Child, Preschool
  • Conjunctiva / pathology
  • Conjunctiva / ultrastructure
  • Europe / ethnology
  • Female
  • Humans
  • Male
  • Microscopy, Electron
  • Muscles / pathology
  • Muscles / ultrastructure
  • Neuronal Ceroid-Lipofuscinoses / epidemiology*
  • Neuronal Ceroid-Lipofuscinoses / pathology
  • Neuronal Ceroid-Lipofuscinoses / physiopathology
  • Peripheral Nerves / pathology
  • Peripheral Nerves / ultrastructure
  • Retrospective Studies
  • Sex Ratio
  • Skin / pathology
  • Skin / ultrastructure