Estamos realizando la búsqueda. Por favor, espere...
Abstract: The aim of this study was to describe five patients with cerebellar ataxia, neuropathy and vestibular areflexia syndrome
(CANVAS) with chronic cough and preserved limb muscle stretch reflexes. All five patients were in the seventh decade of age,
their gait imbalance having been initiated in the fifth decade. In four patients cough antedated gait imbalance between 15 and
29 years; cough was spasmodic and triggered by variable factors. Established clinical picture included severe hypopallesthesia
predominating in the lower limbs with postural imbalance, and variable degree of cerebellar axial and appendicular ataxia,
dysarthria and horizontal gaze-evoked nystagmus. Upper- and lower-limb tendon jerks were preserved, whereas jaw jerk
was absent. Vestibular function testing showed bilateral impairment of the vestibulo-ocular reflex. Nerve conduction studies
demonstrated normal motor conduction parameters and absence or severe attenuation of sensory nerve action potentials.
Somatosensory evoked potentials were absent or severely attenuated. Biceps and femoral T-reflex recordings were normal,
while masseter reflex was absent or attenuated. Sympathetic skin responses were normal. Cranial MRI showed vermian and
hemispheric cerebellar atrophy predominating in lobules VI, VII and VIIa. We conclude that spasmodic cough may be an
integral part of the clinical picture in CANVAS, antedating the appearance of imbalance in several decades and that sparing
of muscle spindle afferents (Ia fibres) is probably the pathophysiological basis of normoreflexia.
Fuente: J Neurol. 2018 Jun;265(6):1454-1462
Año de publicación: 2018
Nº de páginas: 9
Tipo de publicación: Artículo de Revista
Url de la publicación: https://doi.org/10.1007/s00415-018-8872-1
JON INFANTE CEBERIO
SERRANO CÁRDENAS, KARLA M.
GONZÁLEZ AGUADO, ROCÍO
LUCAS, ENRIQUE M. DE
JOSE ANGEL BERCIANO BLANCO