[Fragile X premutation presenting as postural tremor and ataxia (FXTAS syndrome)]
P Davous1, R Juntas Morales, C Dupel-Pottier
1Service de Neurologie, Centre Hospitalier Victor-Dupouy, Argenteuil. patrick.davous@ch-argenteuil.fr
Abstract:
We report a case of FXTAS in a 58-year-old man who presented with postural tremor, mild ataxia and dysexecutive cognitive signs. The syndrome had a slow progressive course. Brain imaging by MRI showed characteristic abnormalities with mild cerebellar atrophy, symmetric high signals in the middle cerebellar peduncles and in the subcortical white matter of cerebral hemispheres. The diagnosis was confirmed by molecular genetics showing by southern blot a 100-120 expansion repeat of the CGG trinucleotide. FXTAS is a recently described syndrome, still unknown by most neurologists and probably rather frequent in men older than 60. We emphasize the value of clinical evaluation and brain imaging by MRI in some patients presenting with non specific motor or cognitive symptoms. A diagnosis of FXTAS may have implications for genetic counselling of female relatives.
Insights
Fragile X-associated Tremor/Ataxia Syndrome (FXTAS) is a progressive neurological disorder. Early diagnosis via clinical evaluation and MRI is crucial for patient management and genetic counseling.
Area of Science:
- Neurology
- Genetics
Background:
- FXTAS is a recently identified neurodegenerative disorder primarily affecting older men.
- It is characterized by progressive motor and cognitive deficits.
Observation:
- A 58-year-old man presented with postural tremor, ataxia, and cognitive dysfunction.
- MRI revealed cerebellar atrophy and white matter abnormalities in the brain.
- Molecular genetics confirmed a CGG trinucleotide repeat expansion.
Findings:
- The patient's symptoms and imaging findings are consistent with FXTAS.
- Southern blot analysis identified a 100-120 repeat expansion, confirming the diagnosis.
- FXTAS may be underdiagnosed, particularly in men over 60.
Implications:
- Highlights the importance of considering FXTAS in patients with nonspecific neurological symptoms.
- Emphasizes the diagnostic utility of MRI and molecular testing.
- Diagnosis has significant implications for genetic counseling of at-risk female relatives.
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