Charcot-Marie-Tooth disease masquerading as acute demyelinating encephalomyelitis-like illness

Pediatrics. 2014 Jul;134(1):e270-3. doi: 10.1542/peds.2012-3243.

Abstract

X-linked Charcot-Marie-Tooth disease (CMTX1) is a clinically heterogeneous hereditary motor and sensory neuropathy with X-linked transmission. Common clinical manifestations of CMTX1 disease, as in other forms of Charcot-Marie-Tooth (CMT) disease, are distal muscle wasting and weakness, hyporeflexia, distal sensory disturbance, and foot deformities. Mutations in the connexin-32 gene (gap junction protein β1 [GJB1]) are responsible for CMTX1 disease. In this report, we describe a patient with CMTX1 disease presenting with recurrent attacks of transient and episodic acute demyelinating encephalomyelitis (ADEM)-like symptoms without previous signs of lower extremity weakness or foot deformities; the patient, as well as his asymptomatic mother, exhibited a novel GJB1 mutation (p.Met1Ile). Differential diagnosis of recurrent and transient ADEM-like illness, if unexplained, should include the possibility of CMTX1 disease.

Keywords: Charcot-Marie-Tooth disease; connexin 32; encephalomyelitis, acute disseminated; peripheral nervous system diseases.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adolescent
  • Charcot-Marie-Tooth Disease / diagnosis*
  • Demyelinating Diseases / diagnosis*
  • Diagnosis, Differential
  • Encephalomyelitis / diagnosis*
  • Humans
  • Male

Supplementary concepts

  • Charcot-Marie-Tooth disease, X-linked, 1