Table 1.
Patients | V-2 | V-3 | V-4 | V-6 | BBGD | Wernicke's-like | |
---|---|---|---|---|---|---|---|
Present age | 18Y | 12Y(dead) | 9Y(dead) | 6Y | 9-33Y | ND | |
Sex | male | male | male | male | male, female | male | |
Consanguinity | + | + | + | + | +/- | - | |
Neurological findings | |||||||
bad temper | 1M | 2M | 2M | 2M | ND | ND | |
head control | - | - | - | - | + | + | |
opisthotonic posture | 1M | - | 2M | 11M | ++ | - | |
mental retardation | ++ | ++ | ++ | ++ | ++ (without treatment) | - | |
dysphagia | ++ | ++ | ++ | + | + | - | |
pyramidal signs | ++ | ++ | ++ | ++ | ++ | - | |
quadriplegia | ++ | ++ | ++ | ++ | ++ | - | |
dystonia | - | - | - | - | ++ | - | |
cogwheel rigidity | - | - | - | - | ++ | - | |
ophthalmoplegia | - | - | - | - | + | ++ | |
nystagmus | - | - | - | - | - | ++ | |
ataxia | - | - | - | - | - | ++ | |
Seizure | |||||||
onset | 2M | 3M | 2M | 11M | childhood | second decade | |
type | ES→SGE | ES→SGE | ES→SGE | ES→PE | PE, SGE | PE | |
Gastrostomy | 12Y | 7Y | 6Y | - | - | - | |
Tracheotomy | - | 4Y | 4Y | - | - | - | |
Pathologic brain MRI findings | 11M | 7Y | 6Y | 14M | 3-33Y | 36Y | |
cerebral atrophy | ++ | ++ | ++ | ++ | - | - | |
cerebellar atrophy | ++ | + | ++ | + | - | - | |
brain stem atrophy | + | - | - | - | - | - | |
Abnormal signals in | |||||||
thalamus | + | + | + | + | - | + | |
caudate nuclei | + | + | + | + | + | - | |
putamen | + | + | + | + | + | - | |
cortical & subcortical region | - | - | - | - | + | - | |
periaqueductal region | - | - | - | - | - | + | |
Treatment | NP | NP | NP | biotin: ineffective | biotin (and thiamin): effective | thiamin: effective |
Y = year(s); M = month(s); ES = epileptic spasm; SGE = symptomatic generalized epilepsy; PE = partial epilepsy; (+) = presence of clinical signs, + to ++ increasing severity; (-) = minus sign; ND = not described; NP = not performed. Typical clinical and brain MRI findings of BBGD [10,16] and Wernicke's-like encephalopathy [12] are summarized.