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Cerebellar Ataxia With Spasmodic Cough
A New Form of Dominant Ataxia
Paula Coutinho, MD, PhD;
Vítor T. Cruz, MD;
Assunção Tuna, MD;
Sérgio E. Silva, MD;
João Guimarães, MD
Arch Neurol. 2006;63:553-555.
Background Although mentioned in most series, "pure" autosomal dominant cerebellar ataxias, except spinocerebellar ataxia type 6, are difficult to differentiate on clinical grounds.
Objective To describe Portuguese families with a peculiar pure form of dominant ataxia that, to our knowledge, has never been documented before and in which cerebellar signs are preceded by spasmodic cough.
Patients Through a population-based survey of hereditary ataxias in Portugal, we identified 19 patients in 6 families with this particular disorder.
Results The majority of patients had a pure late-onset ataxia with a benign evolution. In all of the families, attacks of spasmodic coughing preceded ataxia for 1 to 3 decades and were a reliable marker of the disease. In Portugal, this form of ataxia accounts for 2.7% of all of the dominant ataxias.
Conclusions The families that we describe shared some relevant clinical and imagiological features with spinocerebellar ataxia type 5 and the recently described spinocerebellar ataxia type 20, allelic to spinocerebellar ataxia type 5. Spinocerebellar ataxia types 5 and 20 could be different phenotypic expressions of the same molecular disorder. The association of a dominant ataxia with spasmodic cough is rare but probably underdiagnosed.
Author Affiliations: UnIGENe, IBMC, Universidade do Porto (Dr Coutinho), and Department of Neurology, Hospital Santo António (Dr Tuna), Porto, Portugal; Department of Neurology, Hospital de São Sebastião, Santa Maria da Feira, Portugal (Drs Coutinho, Cruz, and Silva); and Department of Neurology, Hospital Egas Moniz, Lisbon, Portugal (Dr Guimarães).
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