S. Giuffrida et al., Identification of SCA2 mutation in cases of spinocerebellar ataxia with nofamily history in mid-eastern Sicily, ITAL J NEUR, 20(4), 1999, pp. 217-221
Differential diagnosis between autosomal dominant cerebellar ataxia type I
(ADCA I) and idiopathic cerebellar ataxia type P (IDCA-P) is very difficult
given only clinical and neuroradiological data. The only certain distincti
ve characteristic is the presence or absence of family history. We observed
7 patients with late-onset cerebellar ataxia associated with other non-cer
ebellar signs and without a family history of the disease in which clinical
signs were comparable to symptoms found in SCA2. The neuroradiological stu
dy showed olivopontocerebellar atrophy in all patients and the presence of
hyperintensity of the transverse pontine fibers in 6 patients (85.6%); mole
cular analysis showed SCA2 mutations in 2 patients. We also report the case
of a patient who was initially considered as IDCA-P but who was later corr
ectly identified as SCA2 with an atypical family history (false IDCA-P), af
ter a genetic mutation was found and following an interview with the mother
. Our data suggest that spinocerebellar ataxia syndrome should be defined a
s idiopathic not only after having excluded the possible symptomatic causes
but also in the absence of family history, after having excluded the prese
nce of genetic mutation. We believe that family history, in late-onset spin
ocerebellar ataxia, cannot be considered as the differential criterion amon
g hereditary (ADCA-I) and non-hereditary (IDCA-P) forms; molecular analysis
is required for a correct diagnosis.