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Ghadery CM, Kalia LV, Connolly BS. Movement disorders of the mouth: a review of the common phenomenologies. J Neurol 2022; 269:5812-5830. [PMID: 35904592 DOI: 10.1007/s00415-022-11299-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022]
Abstract
Movement disorders of the mouth encompass a spectrum of hyperactive movements involving the muscles of the orofacial complex. They are rare conditions and are described in the literature primarily in case reports originating from neurologists, psychiatrists, and the dental community. The focus of this review is to provide a phenomenological description of different oral motor disorders including oromandibular dystonia, orofacial dyskinesia and orolingual tremor, and to offer management strategies for optimal treatment based on the current literature. A literature search of full text studies using PubMed/Medline and Cochrane library combined with a manual search of the reference lists was conducted until June 2021. Results from this search included meta-analyses, systematic reviews, reviews, clinical studies, case series, and case reports published by neurologists, psychiatrists, dentists and oral and maxillofacial surgeons. Data garnered from these sources were used to provide an overview of most commonly encountered movement disorders of the mouth, aiding physicians in recognizing these rare conditions and in initiating appropriate therapy.
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Affiliation(s)
- C M Ghadery
- Division of Neurology, Department of Medicine, McMaster University, 237 Barton Street East, Hamilton, ON, L8L 2X2, Canada
| | - L V Kalia
- Division of Neurology, Department of Medicine, Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada
| | - B S Connolly
- Division of Neurology, Department of Medicine, McMaster University, 237 Barton Street East, Hamilton, ON, L8L 2X2, Canada.
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2
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Roulis E, Hyland C, Flower R, Gassner C, Jung HH, Frey BM. Molecular Basis and Clinical Overview of McLeod Syndrome Compared With Other Neuroacanthocytosis Syndromes. JAMA Neurol 2018; 75:1554-1562. [DOI: 10.1001/jamaneurol.2018.2166] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Eileen Roulis
- Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Catherine Hyland
- Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Robert Flower
- Australian Red Cross Blood Service, Kelvin Grove, Queensland, Australia
| | - Christoph Gassner
- Blood Transfusion Service Zurich, Swiss Red Cross, Schlieren/Zürich, Switzerland
| | - Hans H. Jung
- Department of Neurology, University and University Hospital Zurich, Zurich, Switzerland
| | - Beat M. Frey
- Blood Transfusion Service Zurich, Swiss Red Cross, Schlieren/Zürich, Switzerland
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Shen Y, Liu X, Long X, Han C, Wan F, Fan W, Guo X, Ma K, Guo S, Wang L, Xia Y, Liu L, Huang J, Lin Z, Xiong N, Wang T. Novel VPS13A Gene Mutations Identified in Patients Diagnosed with Chorea-acanthocytosis (ChAc): Case Presentation and Literature Review. Front Aging Neurosci 2017; 9:95. [PMID: 28446873 PMCID: PMC5388735 DOI: 10.3389/fnagi.2017.00095] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 03/27/2017] [Indexed: 11/13/2022] Open
Abstract
Chorea-acanthocytosis (ChAc) is a rare autosomal recessive inherited syndrome characterized by hyperkinetic movements, seizures, cognitive impairment, neuropsychiatric symptoms, elevated serum biochemical indicators and acanthocytes detection in peripheral blood smear. Vacuolar protein sorting 13A (VPS13A) gene mutations have been proven to be genetically responsible for the pathogenesis of ChAc. Herein, based on the typical clinical symptoms and neuroimaging features, we present two suspected ChAc cases which are further genetically confirmed by four novel VPS13A gene mutations. Nevertheless, the sharp contrast between the population base and published ChAc reports implies that ChAc is considerably underdiagnosed in China. Therefore, we conclude several suggestive features and propose a diagnostic path of ChAc from a clinical, genetic and neuroimaging perspective, aiming to facilitate the diagnosis and management of ChAc in China.
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Affiliation(s)
- Yan Shen
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China
| | - Xiaoming Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China
| | - Xi Long
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China
| | - Chao Han
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China
| | - Fang Wan
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China
| | - Wenliang Fan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China
| | - Xingfang Guo
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China
| | - Kai Ma
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China
| | - Shiyi Guo
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China
| | - Luxi Wang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China
| | - Yun Xia
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China
| | - Ling Liu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China
| | - Jinsha Huang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China
| | - Zhicheng Lin
- Department of Psychiatry, Division of Alcohol and Drug Abuse, and Mailman Neuroscience Research Center, McLean Hospital, Harvard Medical School, BelmontMA, USA
| | - Nian Xiong
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China
| | - Tao Wang
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhan, China
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Benninger F, Afawi Z, Korczyn AD, Oliver KL, Pendziwiat M, Nakamura M, Sano A, Helbig I, Berkovic SF, Blatt I. Seizures as presenting and prominent symptom in chorea-acanthocytosis with c.2343delVPS13Agene mutation. Epilepsia 2016; 57:549-56. [DOI: 10.1111/epi.13318] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2015] [Indexed: 12/20/2022]
Affiliation(s)
- Felix Benninger
- Department of Neurology; Rabin Medical Center; Beilinson Hospital; Petach Tikva Israel
| | - Zaid Afawi
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Amos D. Korczyn
- Department of Neurology; Tel Aviv University; Tel Aviv Israel
| | - Karen L. Oliver
- Department of Medicine; Epilepsy Research Centre; University of Melbourne; Austin Health; Melbourne Victoria Australia
| | - Manuela Pendziwiat
- Department of Neuropediatrics; University Medical Center Schleswig-Holstein; Christian Albrechts University; Kiel Germany
| | - Masayuki Nakamura
- Department of Psychiatry; Kagoshima University Graduate School of Medical and Dental Sciences; Sakuragaoka Kagoshima Japan
| | - Akira Sano
- Department of Psychiatry; Kagoshima University Graduate School of Medical and Dental Sciences; Sakuragaoka Kagoshima Japan
| | - Ingo Helbig
- Department of Neuropediatrics; University Medical Center Schleswig-Holstein; Christian Albrechts University; Kiel Germany
- Division of Neurology; The Children's Hospital of Philadelphia; Philadephia Pennsylvania U.S.A
| | - Samuel F. Berkovic
- Epilepsy Research Centre; Department of Medicine; Austin Health; The University of Melbourne; Heidelberg Victoria Australia
| | - Ilan Blatt
- Department of Neurology; Sheba Medical Center; Tel Hashomer Israel
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Merwick Á, Mok T, McNamara B, Parfrey NA, Moore H, Sweeney BJ, Hand CK, Ryan AM. Phenotypic Variation in a Caucasian Kindred with Chorea-Acanthocytosis. Mov Disord Clin Pract 2014; 2:86-89. [PMID: 30713887 DOI: 10.1002/mdc3.12117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 10/15/2014] [Accepted: 10/17/2014] [Indexed: 11/06/2022] Open
Affiliation(s)
- Áine Merwick
- National Neuroscience Center Cork University Hospital Cork Ireland.,National Hospital for Neurology and Neurosurgery London United Kingdom
| | - Tzehow Mok
- National Neuroscience Center Cork University Hospital Cork Ireland.,National Hospital for Neurology and Neurosurgery London United Kingdom
| | - Brian McNamara
- National Neuroscience Center Cork University Hospital Cork Ireland
| | | | - Helena Moore
- National Neuroscience Center Cork University Hospital Cork Ireland
| | - Brian J Sweeney
- National Neuroscience Center Cork University Hospital Cork Ireland
| | - Collette K Hand
- Department of Pathology University College Cork Cork Ireland
| | - Aisling M Ryan
- National Neuroscience Center Cork University Hospital Cork Ireland
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Aasly J, Sando S, Undeland M, Waage A. [A young woman with adverse effects of neuroleptics]. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2009; 129:33-5. [PMID: 19174851 DOI: 10.4045/tidsskr.2009.18530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Singer C, Papapetropoulos S. A case of seizures, orofacial dyskinesias and peripheral neuropathy. Mov Disord 2008. [DOI: 10.3109/9780203008454-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gold MM, Shifteh K, Bello JA, Lipton M, Kaufman DM, Brown AD. Chorea-acanthocytosis: A Mimicker of Huntington Disease Case Report and Review of the Literature. Neurologist 2006; 12:327-9. [PMID: 17122731 DOI: 10.1097/01.nrl.0000245817.18773.f4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Neuroacanthocytosis consists of a group of rare heterogeneous neurodegenerative disorders associated with acanthocytosis. Chorea-acanthocytosis, a variety of neuroacanthocytosis, is an autosomal recessive condition with clinical and radiologic features similar to Huntington disease. Although difficult, distinguishing between these entities is crucial as the implications for genetic counseling are significant. REVIEW SUMMARY We report the case of a 33-year-old female who presented to our institution with a 3-year history of chorea. The patient's prominent orofacial symptoms and the presence of acanthocytes on peripheral blood smear led to the correct diagnosis of chorea-acanthocytosis. CONCLUSIONS The significant similarities between chorea-acanthocytosis and Huntington disease at the clinical and radiologic levels can lead to an initial misdiagnosis. Clinical clues suggestive of chorea-acanthocytosis include prominent orofacial dyskinesias, often causing dysarthria and dysphagia. Acanthocytosis, when present on peripheral blood smear, can confirm the diagnosis.
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Affiliation(s)
- Menachem M Gold
- Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY 10467, USA.
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Al-Asmi A, Jansen AC, Badhwar A, Dubeau F, Tampieri D, Shustik C, Mercho S, Savard G, Dobson-Stone C, Monaco AP, Andermann F, Andermann E. Familial temporal lobe epilepsy as a presenting feature of choreoacanthocytosis. Epilepsia 2005; 46:1256-63. [PMID: 16060937 DOI: 10.1111/j.1528-1167.2005.65804.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE Choreoacanthocytosis (ChAc) is an autosomal recessive disorder caused by mutations in VPS13A on chromosome 9q21 and characterized by neurodegeneration and red cell acanthocytosis. Seizures are not uncommon in ChAc but have not been well characterized in the literature. We report two ChAc families in which patients presented with temporal lobe epilepsy. METHODS Detailed medical and family histories were obtained. EEG, video-telemetry, brain magnetic resonance imaging (MRI) with volumetric studies of amygdala and hippocampus, as well as neuropsychological testing were performed. Blood smears were examined for acanthocytosis. Mutation analysis of VPS13A was carried out in five patients. RESULTS Six patients in three sibships were initially seen with seizures. Age at seizure onset ranged from 22 to 38 years. Seizures preceded other clinical manifestations of ChAc by < or = 15 years. The epileptic aura consisted of a sensation of déjà-vu, fear, hallucinations, palpitations, or vertigo. EEG with video-telemetry showed epileptiform discharges originating either from one or both temporal lobes. Epilepsy was generally well controlled, but some patients had periods of increased seizure frequency requiring treatment with multiple antiepileptic drugs (AEDs). Both families shared a deletion of exons 70-73 of VPS13A, extending to exons 6-7 of GNA14. CONCLUSIONS Temporal lobe epilepsy may be the presenting feature of ChAc and may delay its diagnosis. Epilepsy in ChAc patients represents a challenge, because seizures may at times be difficult to control, and some AEDs may worsen the involuntary movements. Mutations in VPS13A or GNA14 or both may be associated with clinical features of temporal lobe epilepsy.
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Affiliation(s)
- Abdullah Al-Asmi
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
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Danek A, Jung HH, Melone MAB, Rampoldi L, Broccoli V, Walker RH. Neuroacanthocytosis: new developments in a neglected group of dementing disorders. J Neurol Sci 2005; 229-230:171-86. [PMID: 15760637 DOI: 10.1016/j.jns.2004.11.024] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Neurological abnormalities associated with spiculated, "acanthocytic" red cells in blood have been summarized as neuroacanthocytosis. This is a heterogeneous group of conditions that can now be clearly subdivided on the basis of genetic discoveries. The core neuroacanthocytosis syndromes are autosomal recessive chorea-acanthocytosis (ChAc) and the X-linked McLeod syndrome (MLS). Huntington's disease-like 2 (HLD2) and pantothenate kinase associated neurodegeneration (PKAN) can now also be included. All of these share dyskinesias, cognitive deterioration and progressive neurodegeneration mainly of the basal ganglia, but they are sufficiently distinct to permit a specific working diagnosis on the basis of clinical, laboratory and imaging findings. In addition, the VPS13A (formerly called CHAC), XK, JPH3 and PANK2 genes, respectively, may be examined for mutations. Unfortunately, little is yet known about the normal and abnormal physiology of the protein products of these genes, but they appear to be involved in membrane function and intracellular protein sorting. Since no cures are yet available, development and study of disease models in experimental animals (mouse, C. elegans) is a priority for current research. From a clinical point of view, the common occurrence of cardiomyopathy in MLS, the transfusion hazards due to the McLeod Kell phenotype and the possibility of improving the violent trunk spasms and orofacial dyskinesias typical for ChAc (with subsequent lip or tongue mutilations and feeding dystonia) by deep brain surgery or stimulation should be considered in patient management.
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Affiliation(s)
- Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität Marchioninistr. 15 D-81366 Munich, Germany.
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