Friedreich’s ataxia is a rare disease passed down through families (inherited) that affects the muscles and heart.
Causes, incidence, and risk factors
Friedreich’s ataxia is caused by a defect in a gene called Frataxin (FXN). This gene is located on chromosome 9. Changes in this gene cause the body to make too much of a part of DNA called trinucleotide repeat (GAA). Normally, the body contains about 8 to 30 copies of GAA. Those with Friedreich’s ataxia have as many as 1,000 copies. The more copies of GAA a patient has, the earlier in life the disease starts and the faster it gets worse.
Friedreich’s ataxia is an
Symptoms are caused by the wearing away of structures in areas of the brain and spinal cord that control coordination, muscle movement, and other functions. Symptoms generally begin in childhood before puberty, and may include:
- Changes in vision, particularly color vision
- Decrease in ability to feel vibrations in lower limbs
- Foot problems, such as
hammer toeand high arches
- Hearing loss — occurs in about 10% of patients
Jerky eye movements Loss of coordinationand balance, which leads to frequent falls Muscle weakness
- No reflexes in the legs
Unsteady gaitand uncoordinated movements ( ataxia) — gets worse with time
Muscle problems lead to changes in the spine, which may result in
Heart disease usually develops and may lead to
Signs and tests
The following tests may be done:
- Electrophysiological studies
- Genetic testing
Nerve conduction tests Muscle biopsy X-ray, CTscan, or MRI of the head X-ray of the chest X-ray of the spine
Blood sugar (glucose) tests may reveal diabetes or glucose intolerance. An eye exam may show damage to the optic nerve, which usually occurs without symptoms.
Treatment for Friedreich’s ataxia includes:
Walking aids or wheelchairs
Orthopedic interventions (such as braces) may be needed for scoliosis and foot problems. Treatment of heart disease and diabetes may help improve the quality and duration of life.
Friedreich’s ataxia slowly gets worse and causes problems performing everyday activities. Most patients need to use a wheelchair within 15 years of the disease’s start. The disease may lead to early death.
Calling your health care provider
Call your health care provider if
Individuals with a family history of Friedreich’s ataxia who intend to have children should consider genetic screening and counseling to determine their risk.