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Brain Advance Access originally published online on July 8, 2004
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Brain, Vol. 127, No. 9, 2124-2130, September 2004
© 2004 Guarantors of Brain
doi: 10.1093/brain/awh232

The phenotype of motor neuropathies associated with BSCL2 mutations is broader than Silver syndrome and distal HMN type V

Joy Irobi1, Peter Van den Bergh3, Luciano Merlini4, Christine Verellen5, Lionel Van Maldergem6, Ines Dierick1, Nathalie Verpoorten1, Albena Jordanova1, Christian Windpassinger7, Els De Vriendt1, Veerle Van Gerwen1, Michaela Auer-Grumbach7, Klaus Wagner7, Vincent Timmerman1 and Peter De Jonghe1,2

1 Department of Molecular Genetics, Flanders Interuniversity Institute for Biotechnology, University of Antwerp, Antwerp, 2 Division of Neurology, University Hospital Antwerp, Antwerp, 3 Service de Neurologie, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium, 4 Neuromuscular Laboratory, Istituto Ortopedico Rizzoli, Bologna, Italy, 5 Unité de Génétique Médicale, Brussels, 6 Centre de Génétique Humaine, Institut de Pathologie et de Génétique, Loverval, Belgium and 7 Institute of Medical Biology and Human Genetics, Medical University Graz, Austria
J. Irobi, P. Van den Bergh and L. Merlini contributed equally to this work

Correspondence to: Professor Dr P. De Jonghe, MD, PhD, Peripheral Neuropathy Group, Department of Molecular Genetics (VIB8), University of Antwerp, Universiteitsplein 1, B-2610 Antwerpen, Belgium E-mail: peter.dejonghe{at}ua.ac.be

Silver syndrome is a rare autosomal dominant neurodegenerative disorder characterized by marked amyotrophy and weakness of small hand muscles and spasticity in the lower limbs. The locus for Silver syndrome (SPG17) was assigned to a 13 cM region on chromosome 11q12-q14 in a single large pedigree. We recently found heterozygous mutations in the Berardinelli–Seip congenital lipodystrophy (BSCL2, seipin) gene causing SPG17 and distal hereditary motor neuropathy type V (distal HMN V). Here we report the clinical features of two families with heterozygous BSCL2 mutations. Interestingly, both families show a clinical phenotype different from classical Silver syndrome, and in some patients the phenotype is also different from distal HMN V. Patients in the first family had marked spasticity in the lower limbs and very striking distal amyotrophy that always started in the legs. Patients in the second family had distal amyotrophy sometimes starting and predominating in the legs, but no pyramidal tract signs. These observations broaden the clinical phenotype of disorders associated with BSCL2 mutations, having consequences for molecular genetic testing.


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