Patients with mutations in the polymerase gamma gene (POLG) may present with progressive ataxia and in such situations neuroimaging findings may suggest the diagnosis. Herein we report a patient with a POLG gene W748S homozygous mutation and characteristic lesions in the thalamus, cerebellum and inferior olivary nucleus seen on magnetic resonance imaging.
HabekMBarunBAdamecI. Early-onset ataxia with progressive external ophthalmoplegia associated with POLG mutation: Autosomal recessive mitochondrial ataxic syndrome or SANDO?Neurologist2012; 18: 287–289.
2.
WinterthunSFerrariGHeL. Autosomal recessive mitochondrial ataxic syndrome due to mitochondrial polymerase gamma mutations. Neurology2005; 64: 1204–1208.
3.
HorvathRHudsonGFerrariG. Phenotypic spectrum associated with mutations of the mitochondrial polymerase gamma gene. Brain2006; 129: 1674–1684.
4.
StumpfJDSanetoRPCopelandWC. Clinical and molecular features of POLG-related mitochondrial disease. Cold Spring Harb Perspect Biol2013; 5: a011395.
5.
HakonenAHHeiskanenSJuvonenV. Mitochondrial DNA polymerase W748S mutation: A common cause of autosomal recessive ataxia with ancient European origin. Am J Hum Genet2005; 77: 430–441.
6.
MiloneMBrunetti-PierriNTangLY. Sensory ataxic neuropathy with ophthalmoparesis caused by POLG mutations. Neuromuscul Disord2008; 18: 626–632.
7.
Broderick DF, Wippold FJ II, Cornelius RS, et al., Expert Panel on Neurologic Imaging. ACR Appropriateness Criteria® ataxia. [online publication]. Reston (VA): American College of Radiology (ACR), 2012. https://acsearch.acr.org/docs/69477/Narrative/ (2012, accessed 10 August 2015).
SchulteCSynofzikMGasserT. Ataxia with ophthalmoplegia or sensory neuropathy is frequently caused by POLG mutations. Neurology2009; 73: 898–900.
10.
RantamäkiMKraheRPaetauA. Adult-onset autosomal recessive ataxia with thalamic lesions in a Finnish family. Neurology2001; 57: 1043–1049.
11.
Van GoethemGLuomaPRantamakiM. POLG mutations in neurodegenerative disorders with ataxia but no muscle involvement. Neurology2004; 63: 1251–1257.
12.
ArkadirDMeinerVKarniA. Teaching NeuroImages: Hypertrophic olivary degeneration in a young man with POLG gene mutation. Neurology2015; 84: e59.
13.
WongLJNaviauxRKBrunetti-PierriN. Mutations of mitochondrial DNA polymerase gamma A are a frequent cause of autosomal dominant or recessive progressive external ophthalmoplegia. Ann Neurol2002; 52: 211–219.