Pantothenate Kinase-Associated Neurodegeneration
- 863 Downloads
Pantothenate kinase-associated neurodegeneration (PKAN) is a rare clinically complex autosomal recessive genetic disorder due to PANK2 gene mutations. It is one of the syndromes with neurodegeneration with brain iron accumulation (NBIA). Onset is usually in early childhood. Typical clinical features that comprise dystonia, spasticity, retinitis pigmentosa, and pallidal hypointensities with a central area (eye of the tiger sign) on magnetic resonance imaging may be the diagnostic clue. Diagnostic genetic testing is available. Therapy remains symptomatic including drugs, deep brain stimulation, and supportive therapies. Reports on chelating therapies are controversial. A placebo-controlled randomized trial is on the way.
KeywordsNeurodegeneration Brain iron Dystonia Retinitis pigmentosa T2* MRI Spheroids Eye of the tiger sign PANK2 gene Chelating therapy Deep brain stimulation
The video shows a 21-year-old patient with molecularly proven PKAN (c.1253C>T, homozygous). There is generalized dystonia with dystonic grimacing and dystonic eye blinking when performing repetitive movements which are impaired on the right more than the left. There is dystonic posturing of her right leg and foot when walking. She has dysarthria and personality changes (MOV 5245 kb)
- 4.Hayflick SJ. Unraveling the Hallervorden-Spatz syndrome: pantothenate kinase-associated neurodegeneration is the name. CurrOpinPediatr. 2003;15:572–7.Google Scholar
- 14.Srinivasan B, Baratashvili M, van der Zwaag M, et al. Extracellular 4′-phosphopantetheine is a source for intracellular coenzyme A synthesis. Nat Chem Biol. 2015;11:784–92.Google Scholar