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Krygier, M.* ; Zech, M. ; Chylińska, M.* ; Świętoń, D.* ; Zawadzka, M.* ; Pollak, A.* ; Kostrzewa, G.* ; Mazurkiewicz-Bełdzińska, M.* ; Płoski, R.*

The attenuated phenotype of CNTNAP1-related neuropathy mimics spastic-dystonic cerebral palsy.

Am. J. Med. Genet. A:e64154 (2025)
DOI PMC
CNTNAP1 encodes a contactin-associated protein 1, which is essential for formation and organization of myelinated nerve fibers. Biallelic pathogenic variants in CNTNAP1 cause a severe congenital hypomyelinating neuropathy, characterized by hypotonia, arthrogryposis, respiratory failure, and early lethality. We describe two brothers, seven and 13 years old, with spastic tetraparesis and limb dystonia, in whom we identified compound heterozygous variants in CNTNAP1. Comprehensive neurophysiological evaluation revealed an unusual, asymmetric pattern of hypomyelination that spared lower limb nerves. Moreover, brain neuroimaging showed only mild terminal zone hypomyelination. This report extends the phenotypic spectrum of CNTNAP1 encephalopathy to primarily upper motor neuron disease with the predominant spastic features. In addition, it provides further evidence for the association of CNTNAP1 with dystonia. Importantly, CNTNAP1 mutations should be suspected in individuals with unexplained hypotonia and pyramidal syndrome even in the absence of apparent hypomyelination on brain imaging and normal conduction velocities in routinely examined nerves.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Korrespondenzautor
Schlagwörter Cntnap1 ; Cerebral Palsy ; Dystonia ; Hypomyelination ; Neuropathy ; Spasticity; Cntnap1
ISSN (print) / ISBN 0148-7299
e-ISSN 1096-8628
Quellenangaben Band: , Heft: , Seiten: , Artikelnummer: e64154 Supplement: ,
Verlag Wiley
Verlagsort 111 River St, Hoboken 07030-5774, Nj Usa
Nichtpatentliteratur Publikationen
Begutachtungsstatus Peer reviewed
Förderungen Technical University of Munich-Institute for Advanced Study