Table 1. Mutations in CACNA1A underlie three allelic disorders: EA2, FHM and SCA6.
Disease | Core clinical features | Additional features | Inheritance | Mutations | Functional consequences |
---|---|---|---|---|---|
Episodic ataxia type 2 (EA2) | Attacks of ataxia, vomiting, vertigo, oscillopsia lasting hours to days, and interictal nystagmus | Epilepsy, migraine, and progressive cerebellar syndrome | Autosomal dominant | Nonsense and missense mutations, small deletions and insertions, and large deletions | Loss of function |
Familial hemiplegic migraine type 1 (FHM1) | Rare subtype of MA: attacks of hemiparesis and hemisensory disturbance lasting hours to days | Confusion, encephalopathy, ataxia, coma, and seizures | Autosomal dominant | Missense mutations | Gain of function |
Spinocerebellar ataxia type 6 (SCA6) | Late-onset progressive cerebellar ataxia | Autosomal dominant | CAG expansion in C-terminus | Alteration of CaV2.1 channel kinetics; polyglutamine cytotoxicity? |
The clinical and genetic features of each disorder are described. The effect of mutations on CaV2.1 channel function is stated. MA, migraine with aura.