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Sensory stimulus‐sensitive drop attacks and basal ganglia calcification: new findings in a patient with FOLR1 deficiency
Author(s) -
Toelle Sandra P,
Wille David,
Schmitt Bernhard,
Scheer Ianina,
Thöny Beat,
Plecko Barbara
Publication year - 2014
Publication title -
epileptic disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.673
H-Index - 53
eISSN - 1950-6945
pISSN - 1294-9361
DOI - 10.1684/epd.2014.0629
Subject(s) - basal ganglia , ataxia , medicine , anatomy , central nervous system , psychiatry
Loss‐of‐function mutations in the FOLR1 gene (MIM *136430), encoding the folate receptor alpha, impair cerebral folate transport and lead to a progressive neurometabolic disorder. We report on a 5‐year‐old boy with progressive ataxia, from the age of 2 years and 6 months, with myoclonic jerks, regression, and impressive myoclonic tonic spasms with drop attacks, which were partially provoked by touching his face or washing his hands. Delayed myelination and cerebellar atrophy on cranial MRI were important clues to the diagnosis of cerebral folate transport deficiency, which was confirmed by homozygosity for the known nonsense mutation p.R204X in the FOLR1 gene. Computed tomography taken after head injury revealed bilateral calcifications in the basal ganglia as a novel finding in a patient with FOLR1 mutation. [ Published with video sequences ]