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Case Reports
. 2017 Feb;32(2):246-250.
doi: 10.1177/0883073816666221. Epub 2016 Sep 28.

A Novel SUCLA2 Mutation Presenting as a Complex Childhood Movement Disorder

Caterina Garone  1   2 , Juliana Gurgel-Giannetti  3 , Simone Sanna-Cherchi  4 , Sindu Krishna  1 , Ali Naini  5 , Catarina M Quinzii  1 , Michio Hirano  1
Affiliations
Case Reports

A Novel SUCLA2 Mutation Presenting as a Complex Childhood Movement Disorder

Caterina Garone et al. J Child Neurol. 2017 Feb.

Abstract

SUCLA2 defects have been associated with mitochondrial DNA (mtDNA) depletion and the triad of hypotonia, dystonia/Leigh-like syndrome, and deafness. A 9-year-old Brazilian boy of consanguineous parents presented with psychomotor delay, deafness, myopathy, ataxia, and chorea. Despite the prominent movement disorder, brain magnetic resonance imaging (MRI) was normal while 1H-magnetic resonance spectroscopy (MRS) showed lactate peaks in the cerebral cortex and lateral ventricles. Decreased biochemical activities of mitochondrial respiratory chain enzymes containing mtDNA-encoded subunits and mtDNA depletion were observed in muscle and fibroblasts. A novel homozygous mutation in SUCLA2, the first one in the ligase coenzyme A (CoA) domain of the protein, was identified. Escalating doses of CoQ10 up to 2000 mg daily were associated with improvement of muscle weakness and stabilization of the disease course. The findings indicate the importance of screening for mitochondrial dysfunction in patients with complex movement disorders without brain MRI lesions and further investigation for potential secondary CoQ10 deficiency in patients with SUCLA2 mutations.

Keywords: SUCLA2; brain MRI; coenzyme Q10; movement disorders.

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Conflict of interest statement

DECLARATION OF CONFLICTING INTERESTS

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1:
Figure 1:
Panel A-C: Axial, sagittal and coronal T2-weighted brain MRI images showing normal gray and white matter; Panel D: spectral metabolites of brain MRS showing lactate peak. Panel E-H: cytochrome c oxidase (COX) (E), modified Gomori trichrome (F), oil-red-oil (G) and hematoxylin and eosin (H) stains of muscle biopsy showing lipid droplets and ragged fibers.
See this image and copyright information in PMC

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