Autosomal dominant oculopharyngeal muscular dystrophy (OPMD) usually begins
with ptosis or dysphagia during the fifth or sixth decade of life. We stud
ied 7 patients with OPMD symptoms starting before the age of 36 years. AU w
ere found to be homozygotes for the dominant (GCG)(9) OPMD mutation. On ave
rage, disease onset was 18 years earlier than in heterozygotes, and patient
s had a significantly larger number of muscle nuclei containing intranuclea
r inclusions (INIs) (9.4 vs 4.9%).