Autosomal dominant spinocerebellar degeneration.
Appears in early childhood and progresses slowly.
Roussy-Levy Hereditary Areflexic Dystasia;
Lévy-Roussy Syndrome; Symonds-Shaw Syndrome; Abortive type of Friedreich
Disease; Familial Claw-Foot with Absent Tendon Jerks; Hereditary Areflexic
Dystasia; Hereditary Ataxia-Muscular Atrophy Syndrome.
Not exactly known; spinocerebellar degeneration.
Association of truncal ataxia, lower limb muscular
atrophy, bilateral pes cavus, and loss of deep reflexes.
Symptoms first appear in early childhood and
progress slowly throughout life with moderate disability. Beyond ataxia,
loss of reflexes, and muscular atrophy, clinical features can include
scoliosis, absent leg tendon jerks, distal sensory loss, static hand tremor,
abnormal gait, and slow peripheral nerve conduction velocity. Absence of
cerebellar signs, speech disturbances, Babinski sign, and nystagmus.
Evaluate muscular weakness
(clinical) and neurological function (clinical, EMG, somatosensory evoked
potentials, nervous conduction speed).
Careful intraoperative monitoring.
Regional anesthesia is not contraindicated; however, complete information
about the risks involved has to be clearly expressed by the physician and understood by
the patient/parents. Similar to most cases of Friedreich Ataxia, somatosensory evoked
potential intraoperative monitoring during scoliosis surgery should be
Avoid succinylcholine because of the
risk of hyperkalemia as a consequence of muscle denervation.
Friedreich Ataxia (FRDA): A genetic disorder characterized by a
progressive dysfunction of the posterior spinal cord, the cerebellum (ataxia, nystagmus),
and peripheral nerves. It typically becomes apparent by adolescence. Clinical features
include unsteady posture, frequent falling, progressive ataxia characterized by foot
deformities, increasing incoordination of the arms and hands, dysarthria, and nystagmus.
It may also be associated with cardiomyopathy, chest pain, arrythmias, and diabetes
mellitus. All patients have normal intelligence.
Charcot-Marie-Tooth Disease: A hereditary polyneuropathy condition
presenting with distal weakness and muscular atrophy (myopathy). The most common complaint
is distal leg weakness, which manifests as frequent tripping and muscle atrophy. Hand
involvement follows in most cases. Pregnancy may exacerbate a preexisting weakness in 50%
of patients with early-onset disease.
Auer-Grumbach M, Strasser-Fuchs S, Wagner K, et al: Roussy-Levy syndrome
is a phenotypic variant of Charcot-Marie-Tooth syndrome IA associated with a
duplication on chromosome 17p11.2. J Neurol Sci
Roussy G, Lévy G: Sept cas d'une maladie familiale particulière:
Troubles de la marche, pieds bots et aréflexie tendineuse
généralisée, avec, accessoirement, légère maladresse des
mains. Rev Neurol (Paris) 1:427, 1926.