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Cognitive dysfunction in mitochondrial disorders.
[wolf-hirschhorn syndrome]
Among
the
various
central
nervous
system
(
CNS
)
manifestations
of
mitochondrial
disorders
(
MIDs
)
,
cognitive
impairment
is
increasingly
recognized
and
diagnosed
(
mitochondrial
cognitive
dysfunction
)
.
Aim
of
the
review
was
to
summarize
recent
findings
concerning
the
aetiology
,
pathogenesis
,
diagnosis
and
treatment
of
cognitive
decline
in
MIDs
.
Among
syndromic
MIDs
due
to
mitochondrial
DNA
(
mtDNA
)
mutations
,
cognitive
impairment
occurs
in
patients
with
mitochondrial
encephalopathy
,
lactic
acidosis
and
stroke-like
episodes
syndrome
,
myoclonus
epilepsy
with
ragged-
red
fibres
syndrome
,
mitochondrial
chronic
progressive
external
ophthalmoplegia
,
Kearns-
Sayre
syndrome
,
neuropathy
,
ataxia
and
retinitis
pigmentosa
syndrome
and
maternally
inherited
diabetes
and
deafness
.
Among
syndromic
MIDs
due
to
nuclear
DNA
(
nDNA
)
mutations
,
cognitive
decline
has
been
reported
in
myo-neuro-gastro-
intestinal
encephalopathy
,
mitochondrial
recessive
ataxia
syndrome
,
spinocerebellar
ataxia
with
encephalopathy
,
Mohr-
Tranebjaerg
syndrome
,
leuko-
encephalopathy
;
brain
and
spinal
cord
involvement
and
lactic
acidosis
,
CMT
2
,
Wolfram
syndrome
,
Wolf-
Hirschhorn
syndrome
and
Leigh
syndrome
.
In
addition
to
syndromic
MIDs
,
a
large
number
of
non-syndromic
MIDs
due
to
mtDNA
as
well
as
nDNA
mutations
have
been
reported
,
which
present
with
cognitive
impairment
as
the
sole
or
one
among
several
other
CNS
manifestations
of
a
MID
.
Delineation
of
mitochondrial
cognitive
impairment
from
other
types
of
cognitive
impairment
is
essential
to
guide
the
optimal
management
of
these
patients
.
Treatment
of
mitochondrial
cognitive
impairment
is
largely
limited
to
symptomatic
and
supportive
measures
.
Cognitive
impairment
may
be
a
CNS
manifestation
of
syndromic
as
well
as
non-syndromic
MIDs
.
Correct
diagnosis
of
mitochondrial
cognitive
impairment
is
a
prerequisite
for
the
optimal
management
of
these
patients
.
Diseases
Validation
Diseases presenting
"lactic acidosis"
symptom
adrenomyeloneuropathy
alexander disease
cadasil
canavan disease
hereditary cerebral hemorrhage with amyloidosis
homocystinuria without methylmalonic aciduria
neonatal adrenoleukodystrophy
phenylketonuria
pyruvate dehydrogenase deficiency
wolf-hirschhorn syndrome
This symptom has already been validated