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236 patient data entries in database for mutation A467T.

Entry
#
Mutations
allele 1allele 2
Clinical representationSymptomsAge groupAge of onsetAge of patientAge of deathReference
4A467T2
F88L1
Clinical indications reported as N/A only information provided is age of patient and 71% mtDNA copy number in blood.
-no known symptoms
adult
n/a42n/aTang et al, 2011;

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9A467T2
A143V1
Dementia/encephalopathy, headaches/migraines, ataxia, seizures, peripheral neuropathy, exercise intolerance, muscle weakness, easy fatigability, CPEO, abnormal EMG/NCV, hearing loss, cerebellar atrophy, abnormal MRI. 82% mtDNA copy number in blood.
-movement disorder (ataxia)
-cerebellar atrophy
-peripheral neuropathy
-muscle weakness
-exercise intolerance
-PEO
-headache/ migraine
-encephalopathy
-dementia
-hearing loss
adult
n/a49n/aTang et al, 2011;

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13A467T2
R227W4
Onset at 4 months with FTT, dementia, hypotonia, seizures, myoclonus, GI problems, hepatopathy, hearing loss, delayed myelinisation. Death at 10 months
-myoclonic seizures
-delayed myelination
-failure to thrive
-hypotonic
-dementia
-GI problems
-hearing loss
infantile
0.3n/a0.8de Vries et al, 2007;

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16A467T2
R227P4
Severe childhood multi-system disorder, epilepsy and failure to thrive, GI problems, hypotonia, retardation.
-epilepsy
-failure to thrive
-hypotonic
-retardation
-GI problems
infantile
0.5n/a1de Vries et al, 2007;

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17A467T2
R227P4
FTT, died after epilepticus.
-epilepsy
-failure to thrive
infantile
n/an/a1Blok et al, 2009;

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40A467T2
T251I
P587L2
PEO, ptosis, proximal weakness, multiple mtDNA deletions-LPCR. 25% COX-deficient fibers
-ptosis
-PEO
-proximal weakness
adult
45n/an/aStewart et al, 2009;

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41A467T2
T251I
P587L2
Exercise intolerance, CPEO, retinitis pigmentosa, diabetes, limb girdle weakness. 2nd patient with cataract and myopathy
-exercise intolerance
-myopathy
-PEO
adult
n/a51n/aBlok et al, 2009;

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52A467T2
G303R3
Encephalopathy with epilepsy, and liver disease.
-epilepsy
-liver dysfunction
-encephalopathy
infantile
0.9n/a1.1Tzoulis et al, 2010;

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53A467T2
G303R3
Encephalopathy with epilepsy, and liver disease.
-epilepsy
-liver dysfunction
-encephalopathy
infantile
1n/a1.4Tzoulis et al, 2010;

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54A467T2
G303R3
Encephalopathy with epilepsy, ataxia.
-epilepsy
-movement disorder (ataxia)
-encephalopathy
infantile
2n/a8Tzoulis et al, 2010;

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59A467T2
L304R3
myopathy, PEO, dysarthria.
-myopathy
-PEO
-dysarthria
juvenile
16n/a37Van Goethem et al, 2003a;

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60A467T2
L304R3
sensory ataxic neuropathy, PEO, dysarthria.
-sensory ataxia
-PEO
-dysarthria
adult
25n/an/aVan Goethem et al, 2003a;

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65A467T2
S305R3
Liver failure. 51% mtDNA copy number in muscle, 9% mtDNA copy number in liver, 87% mtDNA copy number in blood.
-liver failure
infantile
n/a1n/aTang et al, 2011;

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66A467T2
S305R3
Alpers, died at age four. Sister also died at age 4 .
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
childhood
n/an/a4Blok et al, 2009;

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72A467T2
R417T1
onset at 2 years with encephalopathy no hepatopathy.
-encephalopathy
infantile
2n/an/aAshley et al, 2008;

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73A467T2
C418R1
Onset at 3 years of age, encephalopathy presenting with epilepsy and movement disorder (ataxia).
-epilepsy
-movement disorder (ataxia)
-encephalopathy
childhood
3n/an/aAshley et al, 2008;

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75A467T2
L428P1
Alpers, cerebellar ataxia at age 2, seizures at age 3, RC deficiency in liver, hepatocellular insufficiency after valproate treatment at age 3.6, death at age 3.8. 8% mtDNA copy number in liver.
-cerebellar ataxia
-movement disorder (ataxia)
-liver dysfunction
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
infantile
2n/a3.8Sarzi et al, 2007;

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79W748S5
E1143G
A467T2
Ptosis, CPEO, polyneuropathy, cerebellar ataxia, dysarthria.
-cerebellar ataxia
-movement disorder (ataxia)
-polyneuropathy
-ptosis
-PEO
-dysarthria
adult
n/a47n/aBlok et al, 2009;

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80G11D
R852C1
A467T2
Alpers, seizures, abnormal liver function, mild lactic acidosis, normal histology of COX fibers.
-lactic acidosis
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
infantile
1.25n/an/aStewart et al, 2009;

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81A467T2
A467T2
Onset 32 years with neuropathy, myopathy, SANDO, PEO.
-myopathy
-PEO
adult
32n/an/aWong et al, 2008;

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82A467T2
A467T2
Stroke/ischaemic episodes, ataxia, seizures, myoclonic seizures, peripheral neuropathy, CPEO. 114% mtDNA copy number in blood.
-myoclonic seizures
-movement disorder (ataxia)
-peripheral neuropathy
-PEO
-stroke
-ischaemic episodes
adult
n/a40n/aTang et al, 2011;

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83A467T2
A467T2
Age 19.6, developmental delay, after 18 years, rapid onset of muscle weakness, ataxia, myoclonic seizures, optic atrophy, diplopia, dysarthria. 102% mtDNA copy number in blood.
-myoclonic seizures
-movement disorder (ataxia)
-optic atrophy
-muscle weakness
-diplopia
-developmental delay
-dysarthria
juvenile
1820n/aTang et al, 2011;

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84A467T2
A467T2
PEO, ataxia, seizures, encephalopathy, ptosis, sensory neuropathy, mtDNA multiple deletions. 20% COX deficient fibers, 3% ragged red fibers.
-movement disorder (ataxia)
-ragged red fibers
-ptosis
-PEO
-encephalopathy
childhood
12n/an/aStewart et al, 2009;

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85A467T2
A467T2
PEO, ataxia, ataxic sensory axonal neuropathy, dysarthria, multiple mtDNA deletions. 10% COX deficient fibers, 2% RRF.
-movement disorder (ataxia)
-demyelinating neuropathy
-PEO
-dysarthria
adult
30n/an/aStewart et al, 2009;

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86A467T2
A467T2
Ataxia, peripheral neuropathy, muscle weakness, easy fatigability, CPEO, abnormal EMG/NCV, ptosis, delayed gastric emptying, diarrhoea, constipation, lactic acidosis, abnormal muscle ultratstructure, ragged red fibers. 75% mtDNA copy number in blood.
-lactic acidosis
-movement disorder (ataxia)
-peripheral neuropathy
-ragged red fibers
-muscle weakness
-ptosis
-PEO
-delayed gastric emptying
adult
n/a46n/aTang et al, 2011;

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87A467T2
A467T2
Onset 23 years with ataxia, neuropathy, hearing loss, seizures, and VPA liver failure. From "Saneto et al, 2010": Sensory neuropathy, ataxia, seizure onset at 15 years, simple partial seizure and epilepsia partialis continua myoclonus, VPA treatment caused liver failure after 3 months, progressive encephalopathy, Sensorineural hearing loss, dysmetria, intention tremor, hypotonia
-myoclonic seizures
-epilepsia partialis
-movement disorder (ataxia)
-liver failure
-hypotonic
-encephalopathy
-tremor
-hearing loss
juvenile
152323.5Wong et al, 2008;

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90W748S5
A467T2
MELAS-like, features including occipital lobe epilepsy.
-epilepsy
juvenile
n/a19n/aBlok et al, 2009;

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91P1073L3
A467T2
Psychomotor delay, seizures, liver disease, GI dysmotility, lactic acidosis, ptosis, hearing loss.
-lactic acidosis
-ptosis
-liver dysfunction
-psychomotor delay
-GI dysmotility
-hearing loss
infantile
0.01n/a0.8Kurt et al, 2010;

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92P1073L3
A467T2
Psychomotor delay, status epilepticus, liver disease, GI dysmotility, lactic acidosis, optic atrophy.
-lactic acidosis
-status epilepticus
-optic atrophy
-liver dysfunction
-psychomotor delay
-GI dysmotility
infantile
0.01n/a3Kurt et al, 2010;

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93S1095R3
A467T2
Hypotonia, hepatic failure, elevated transaminases, respiratory deficiency/failure, FTT, developmental delay, GI reflux, delayed gastric emptying, dicarboxylic aciduria, high CSF protein, abnormal muscle histology, COX deficiency, vomiting. 12% mtDNA copy number in muscle, 42% mtDNA copy number in blood, ETC low. ptosis, poor head control. Central hypotonia, and absent deep tendon reflexes. He developed hypoxia, ascites, tachycardia, intermittent fevers, and sepsis. Some severely cytochrome oxidase-deficient muscle fibers were present.
-abnormal muscle histology
-ptosis
-liver failure
-failure to thrive
-hypotonic
-developmental delay
-vomiting
-GI reflux
-delayed gastric emptying
-respiratory deficiency
infantile
0.333n/a0.583Tang et al, 2011;

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94R807C3
A467T2
Encephalopathy/dementia, liver failure, cholestasis, lactic acidosis, altered mental status. 47% mtDNA copy number in muscle, 8% mtDNA copy number in liver, ETC low.
-lactic acidosis
-liver failure
-encephalopathy
-dementia
-altered mental status
-cholestasis
infantile
n/a1n/aTang et al, 2011;

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95R807H3
A467T2
Developmental delay, hypotonia, seizures, hepatic failure, elevated transaminases, renal tubular disease, failure to thrive. 18% mtDNA copy number in blood.
-liver failure
-failure to thrive
-hypotonic
-developmental delay
infantile
n/a1n/aTang et al, 2011;

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96L886P1
A467T2
Onset 1 years with dementia, seizures, and liver failure. Alpers
-liver failure
-dementia
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
infantile
11n/aWong et al, 2008;

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97T914P1
A467T2
Developmental delay, hypotonia, seizures, myoclonic seizures, hemiparesis, intractable seizure, elevated transaminases, FTT, lactic acidosis, high CSF lactate, elevated pyruvate, high CSF protein, dementia/encephalopathy. 112% mtDNA copy number in muscle, 63% mtDNA copy number in blood.
-lactic acidosis
-myoclonic seizures
-hemiparesis
-intractable seizure
-failure to thrive
-hypotonic
-encephalopathy
-developmental delay
-dementia
infantile
n/a0.9n/aTang et al, 2011;

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98T914P1
A467T2
Onset 2 years with dementia, seizures, and liver failure. Alpers
-liver failure
-dementia
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
infantile
2n/an/aWong et al, 2008;

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99T914P1
A467T2
Onset at 9 months with alpers, death at 12 months. 8% mtDNA copy number in liver, 8% mtDNA copy number in muscle.
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
infantile
0.8n/a1Taanman et al, 2009;

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100T914P1
A467T2
Developmental delay, seizures, myoclonic seizures, intractable seizure, respiratory deficiency/failure, abnormal EEG, abnormal MRI. 60% mtDNA copy number in blood.
-myoclonic seizures
-intractable seizure
-developmental delay
-respiratory deficiency
infantile
n/a0.8n/aTang et al, 2011;

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101T914P1
A467T2
Developmental delay, hypotonia, dementia/encephalopathy, seizures, intractable seizure, lactic acidosis, high CSF lactate, abnormal MRI, no liver problem at 3.5 years. 24% mtDNA copy number in blood.
-lactic acidosis
-intractable seizure
-hypotonic
-encephalopathy
-developmental delay
-dementia
childhood
n/a3n/aTang et al, 2011;

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102T914P1
A467T2
Seizures, hepatic failure, duplicated cyst of ileum, FTT, diarrhea. 13% mtDNA copy number in liver.
-liver failure
-failure to thrive
-diarrhea
infantile
n/a4n/aTang et al, 2011;

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103T914P1
A467T2
Developmental delay, headaches/migraines, seizures, hemiparesis, intractable seizure, high CSF lactate, high CSF protein, hearing loss, abnormal EEG, increased signal basal ganglia, abnormal MRI. 88% mtDNA copy number in blood.
-hemiparesis
-intractable seizure
-headache/ migraine
-developmental delay
-hearing loss
childhood
n/a5n/aTang et al, 2011;

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104T914P1
A467T2
Onset at 4 years with encephalopathy, myoclonus, and SLE.
-myoclonic seizures
-encephalopathy
childhood
48n/aHorvath et al, 2006;

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105T914P1
A467T2
Onset at 1.5 years with encephalopathy and hepatopathy and cortical blindness. Diagnosed as Alpers.
-encephalopathy
-cortical blindness
-Alpers syndrome
-developmental delay
-epilepsy
infantile
1.52n/aHorvath et al, 2006;

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106L966R1
A467T2
Reported as Alpers, onset at 4 years, presenting encephalopathy with epilepsy.
-epilepsy
-encephalopathy
-Alpers syndrome
-developmental delay
childhood
4n/an/aAshley et al, 2008;

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107C1188R1
A467T2
Developmental delay, seizures, abnormal MRI, hypotonia, low in blood.
-hypotonic
-developmental delay
childhood
n/a3n/aTang et al, 2011;

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108K1191N1
A467T2
Onset at .5 years with encephalopathy, liver dysfunction, cardiopathy, diagnosed as Alpers, death at 1.3 years.
-liver dysfunction
-encephalopathy
-cardiopathy
-Alpers syndrome
-developmental delay
-epilepsy
infantile
0.5n/a1.3Horvath et al, 2006;

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109R852C1
G11D
A467T2
Seizures, myoclonic seizures, intractable seizures, hepatic failure, elevated transaminases, Apnes/Hypoventilation, respiratory deficiency/failure, lactic acidosis, organic aciduria/tiglyglycine, low plasma carnitine, abnormal EEG. 108% mtDNA copy number in blood.
-lactic acidosis
-myoclonic seizures
-intractable seizure
-liver failure
-respiratory deficiency
infantile
n/a0.8n/aTang et al, 2011;

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110A957P1
A467T2
Onset at 8 months with FTT, dementia, hypotonia, seizures, hepatopathy, aplasia cutis, delayed myelinisation. Death at 17 months.
-delayed myelination
-failure to thrive
-hypotonic
-dementia
infantile
0.6n/a1.5de Vries et al, 2007;

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111G848S1
A467T2
Onset at 6 months with FTT, dementia, hypotonia, seizures, hepatopathy, aplasia cutis, delayed myelinisation. Death at 15 months.
-delayed myelination
-failure to thrive
-hypotonic
-dementia
infantile
0.5n/a1.3de Vries et al, 2007;

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112G848S1
A467T2
Alpers, seizures, developmental delay, liver failure, hypotonia, impaired vision, renal stones, mtDNA depletion in muscle. 5% COX deficient fibers.
-liver failure
-hypotonic
-developmental delay
-Alpers syndrome
-encephalopathy
-epilepsy
infantile
0.7n/an/aStewart et al, 2009;

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113L605R2
A467T2
Alpers, seizures, myoclonus, liver failure, elevated serum lactate, COX deficient fibers present in muscle and liver, mtDNA depletion in liver.
-myoclonic seizures
-liver failure
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
infantile
1n/an/aStewart et al, 2009;

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114G588D2
A467T2
VPA induced liver failure. 50% mtDNA copy number in muscle.
-liver failure
infantile
n/a2n/aTang et al, 2011;

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115R627W5
A467T2
Onset at 32 years with encephalopathy, PEO, ataxia, dysphagia, myopathy, neuropathy and cardiomyopathy, hearing loss. Death at 41 years.
-movement disorder (ataxia)
-myopathy
-PEO
-encephalopathy
-dysphagia
-hearing loss
adult
32n/a41Horvath et al, 2006;

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116R627W5
A467T2
PEO, SANDO (Horvath 2006 or Van goethem 2003) sensory ataxic neuropathy, PEO, dysarthria.
-sensory ataxia
-PEO
-dysarthria
adult
20n/an/aHorvath et al, 2006;

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117R627W5
A467T2
Onset at 39 years with PEO, ataxia, myopathy, and hearing loss.
-movement disorder (ataxia)
-myopathy
-PEO
-hearing loss
adult
39n/an/aHorvath et al, 2006;

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118H754Q2
A467T2
Developmental delay, intractable seizure/refractory, hepatic failure, cerebellar atrophy, liver failure. 87% mtDNA copy number in blood.
-intractable seizure
-cerebellar atrophy
-liver failure
-developmental delay
infantile
n/a2n/aTang et al, 2011;

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119R574W2
A467T2
Alpers. Alive at 10 years. Sister died at age 27.
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
childhood
310n/aSpinazzola et al, 2009;

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120R597W2
A467T2
Dementia/encephalopathy, ataxia, peripheral neuropathy, ptosis, abnormal muscle histology, abnormal muscle ultrastructure, abnormal respiratory enzyms, large mitochondrial/ proliferation, COX deficiency, ragged red fibers. 100% mtDNA copy number in blood.
-movement disorder (ataxia)
-peripheral neuropathy
-abnormal muscle histology
-abnormal muscle ultrastructure
-ragged red fibers
-ptosis
-encephalopathy
-dementia
adult
n/a26n/aTang et al, 2011;

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121G737R5
A467T2
Onset 60 years with ataxia, neuropathy, myopathy, hearing loss, cerebellar atrophy, SANDO/SCAE, PEO.
-movement disorder (ataxia)
-cerebellar atrophy
-myopathy
-PEO
-hearing loss
adult
60n/an/aWong et al, 2008;

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122W748S5
A467T2
Onset at 34 years with PEO, ataxia, dysphagia, myopathy, neuropathy and Diabetes.
-movement disorder (ataxia)
-myopathy
-PEO
-dysphagia
adult
34n/an/aHorvath et al, 2006;

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123W748S5
A467T2
Dysarthria, sensory neuropathy, PEO, minor cognitive dysfunction, depression.
-PEO
-dysarthria
adult
34n/an/aSchulte et al, 2009;

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124W748S5
A467T2
PEO, ataxia, seizures, ptosis, bilateral deafness, myopathy, dysarthria, peripheral neuropathy, multiple mtDNA deletions. 5% COX deficient fibers, 2% RRF.
-movement disorder (ataxia)
-peripheral neuropathy
-myopathy
-ptosis
-PEO
-dysarthria
-bilateral deafness
adult
39n/an/aStewart et al, 2009;

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125W748S5
A467T2
Autistic features, headaches/migraines, ataxia, seizures, intractable seizure, optic atrophy, abnormal MRI, dystonia, posterior stroke, abnormal EEG. 101% mtDNA copy number in blood.
-intractable seizure
-movement disorder (ataxia)
-optic atrophy
-stroke
-headache/ migraine
-dystonia
juvenile
n/a18n/aTang et al, 2011;

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126F749S5
A467T2
Intractable seizure, abrubt onset of seizure. 15% mtDNA copy number in blood.
-intractable seizure
childhood
n/a6n/aTang et al, 2011;

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127L1113P1
A467T2
Encephalopathy, seizures, pancreatitis, hepatic failure, elevated transaminases, respiratory deficiency/failure, lactic acidosis, mycoplasma infection, pentobarbital induced liver failure. 57% mtDNA copy number in muscle, 78% mtDNA copy number in blood, Complex IV 20%.
-lactic acidosis
-liver failure
-encephalopathy
-pancreatitis
-respiratory deficiency
infantile
n/a1n/aTang et al, 2011;

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128R1138C1
A467T2
Onset 48 years with neuropathy, myopathy, SANDO, lactic acidosis PEO.
-lactic acidosis
-myopathy
-PEO
adult
48n/an/aWong et al, 2008;

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129W748S5
A467T2
Occipital lobe epilepsy, myoclonus, cognitive delay, polyneuropathy, cerebellar ataxia.
-myoclonic seizures
-epilepsy
-cerebellar ataxia
-movement disorder (ataxia)
-polyneuropathy
-cognitive delay
adult
n/a40n/aBlok et al, 2009;

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141A467T2
P625R5
Seizures onset at age 1, death via VPA induced liver failure at age 2.
-liver failure
infantile
1n/a2Baruffini et al, 2011;

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178A467T2
F749S5
Authors report N/A. 6% mtDNA copy number in blood.
-no known symptoms
infantile
n/a0.8n/aTang et al, 2011;

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188A467T2
R852C1
G11D
reported as Alpers, onset at 2 years, presenting encephalopathy with epilepsy, hepatopathy. 22% mtDNA copy number in muscle.
-epilepsy
-encephalopathy
-Alpers syndrome
-developmental delay
infantile
2.25n/an/aAshley et al, 2008;

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198A467T2
T914P1
reported as Alpers, onset at 7 months, presenting encephalopathy with epilepsy, hepatopathy, and movement disorder (ataxia). 39% mtDNA copy number in muscle.
-epilepsy
-movement disorder (ataxia)
-encephalopathy
-Alpers syndrome
-developmental delay
infantile
0.58n/an/aAshley et al, 2008;

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200A467T2
T914P1
Epilepsy, myoclonus, and developmental delay.
-myoclonic seizures
-epilepsy
-developmental delay
infantile
n/a1n/aBlok et al, 2009;

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212A467T2
A957P1
Epilepsy, liver failure, occipital strokes, and growth retardation, death at age 1.
-epilepsy
-liver failure
-growth retardation
-retardation
-occipital strokes
infantile
n/an/a1Blok et al, 2009;

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227A467T2
S1104C1
PEO, bilateral ptosis, severe limita- tion of ocular motility, and a mosaic distribution of ragged-red and cytochrome c oxidase–negative fibers in the muscle biopsy. All patients had multiple deletions of muscle mtDNA.
-ragged red fibers
-ptosis
-PEO
adult
48n/an/aAgostino et al, 2003;

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233W748S5
E1143G
A467T2
psychomotor regression, refractory seizures, stroke-like episodes, hepatopathy, and ataxia. COX-deficient muscle fibers, mtDNA deletions, 160% mtDNA copy number. He was normal until 11 years of age when he developed mild tremor and ataxia. At 13 years of age, he reported occasional migraine-like headaches and was found to have mild ataxia and myoclonus. generalized seizures. mild leftsided hemiparesis, external ophthalmoplegia, and peripheral neuropathy.
-myoclonic seizures
-hemiparesis
-intractable seizure
-movement disorder (ataxia)
-peripheral neuropathy
-cox-deficient muscle
-ophthalmoplegia
-external ophthalmoplegia
-stroke
-headache/ migraine
-stroke-like episodes
-tremor
childhood
1124n/aKollberg et al, 2006;

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234A467T2
G268A3
PEO, age of onset 65 years.
-PEO
adult
65n/an/aDi Fonzo et al, 2003;

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240R627Q5
Q1236H
A467T2
developed progressive blepharoptosis at the age of 20 and ophthalmoplegia during subsequent years, at 35, the patient developed progressive unsteadiness of gait. She noted fatigue, myalgia and cramps, which were triggered by moderate exercise. At 44, restless legs syndrome, deficits in memory and concentration, and suffered from recurrent episodes of depression, at 46 showed bilateral blepharoptosis, limited eye movements in all directions except downwards, lateral rotatory nystagmus and slight upbeat nystagmus in upward gaze, but no saccades. She had facial muscle weakness, dysarthria and slight proximal muscle weakness. She had glove and stockinglike hypoesthesia, distally impaired vibration sense, absent ankle reflexes and weak other tendon reflexes, as well as mild dysmetria. Her gait was broad-based, with further impairment with eyes closed. Tandem gait was impaired. deltoid muscle showed myopathic features, structurally abnormal mitochondria with para-crystalline inclusions,
-muscle weakness
-ptosis
-ophthalmoplegia
-dysarthria
-nystagmus
adult
2046n/aLuoma et al, 2005;

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242A467T2
This 64-year-old woman, the mother of the index patient, developed slowly progressive blepharoptosis at the age of 45. She underwent blepharoplasty at the age of 58. In the neurological examination at the age of 63, she had ptosis, but no other neurological deficits. Late onset ptosis.
-ptosis
adult
4564n/aLuoma et al, 2005;

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243A467T2
This 66-year-old woman developed progressive blepharoptosis slowly at the age of 50. She underwent blepharoplasty at the age of 62, and in the same year, she suffered a transitory ischemic attack. At the age of 66, no clinical findings except ptosis were detectable. Late onset ptosis.
-ptosis
adult
5066n/aLuoma et al, 2005;

[view data]

244A467T2
This 50-year-old woman developed progressive blepharoptosis slowly at the age of 40. She underwent blepharoplasty at the age of 47. Her neurological examination at the age of 50 was normal. Late onset ptosis
-ptosis
adult
4050n/aLuoma et al, 2005;

[view data]

245A467T2
probable mild blepharoptosis, early onset ptosis
-ptosis
adult
n/a23n/aLuoma et al, 2005;

[view data]

256Nonsense
mutation:
W1020X
A467T2
Refractory seizures, psychomotor regression, liver disease, presenting symptom was status epilepticus, Transient hypoglycemia, Transient lactic academia, hypercoagulable state
-status epilepticus
-intractable seizure
-liver dysfunction
-hypoglycemia
infantile
0.8n/a1Nguyen et al, 2005;

[view data]

258A467T2
A467T2
Refractory seizures, psychomotor regression, liver disease, presented with epilepsia partialis continua, Transient lactic acidemia
-lactic acidosis
-intractable seizure
-epilepsia partialis
-liver dysfunction
childhood
8.5n/a9Nguyen et al, 2005;

[view data]

259A467T2
G848S1
Refractory seizures, psychomotor regression, liver disease, presented with liver failure
-intractable seizure
-liver failure
-liver dysfunction
infantile
1n/a1.3Nguyen et al, 2005;

[view data]

260A467T2
G848S1
Refractory seizures, psychomotor regression, liver disease, Transient hypoglycemia, Transient lactic academia, Elevated CSF protein, presented with epilepsia partialis continua,
-intractable seizure
-epilepsia partialis
-liver dysfunction
-hypoglycemia
infantile
0.9n/a1.8Nguyen et al, 2005;

[view data]

262F749S5
A467T2
Alpers
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
unknown
n/an/an/aNguyen et al, 2006;

[view data]

264R852C1
A467T2
Alpers
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
unknown
n/an/an/aNguyen et al, 2006;

[view data]

265T914P1
A467T2
Alpers
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
unknown
n/an/an/aNguyen et al, 2006;

[view data]

266L966R1
A467T2
Alpers
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
unknown
n/an/an/aNguyen et al, 2006;

[view data]

276R1138C1
A467T2
Bilateral ptosis, distal lower limbs paresthesias, dysphagia, imbalance, inattention, ophthalmoparesis, Multiple mtDNA deletions detected by PCR in blood and muscle
-ptosis
-PEO
-dysphagia
adult
4654n/aMilone et al, 2011;

[view data]

277A467T2
A467T2
progressive bilateral ptosis, limited eye movements, lower extremities paresthesias, and unsteadiness, Multiple mtDNA deletions detected by PCR in muscle
-ptosis
adult
3134n/aMilone et al, 2011;

[view data]

280G737R5
A467T2
progressive sensory ataxic neuropathy, ophthalmoparesis, cerebellar ataxia, limb weakness, muscle cramps, sensory hearing loss, dysarthria, dysphagia, constipation, and memory loss, brain MRI was abnormal with evidence of generalized cortical and cerebellar atrophy, evidence of a length-dependent sensory > motor polyneuropathy of axonal type, Multiple mtDNA deletions detected by PCR in blood
-cerebellar ataxia
-movement disorder (ataxia)
-cerebellar atrophy
-sensory ataxia
-polyneuropathy
-PEO
-dysphagia
-dysarthria
-hearing loss
adult
5358n/aMilone et al, 2011;

[view data]

285Splice site
mutation:
c.2157+5_6GC>AG
A467T2
speech and motor delay at 1.5 yr, seizure that included eye deviation, jaw clenching, and hypotonia of the trunk and extremities. He experienced repetitive generalized tonic-clonic seizures that evolved into refractory status epilepticus, severe encephalopathy characterized by choreo-athetoid movements, corticovisual impairment, diffuse hypotonia, and severe swallowing dysfunction, elevated plasma lactate, CSF lactate and protein were both elevated, Liver transaminases remained mildly elevated. dysphagia.
-status epilepticus
-hypotonic
-encephalopathy
-dysphagia
infantile
1.5n/an/aLutz et al, 2009;

[view data]

289A467T2
A467T2
Developemental delay, status epilepticus onset, valproic acid therapy 2 weeks, epilepsia partialis continua, mtDNA depletion in liver
-status epilepticus
-epilepsia partialis
infantile
2.676n/aWolf et al, 2009;

[view data]

290A467T2
A467T2
status epilepticus onset, valproic acid therapy 12 weeks, liver failure,
-status epilepticus
-liver failure
childhood
9.2511n/aWolf et al, 2009;

[view data]

292R275Q3
A467T2
presented with blurred vision, elevated CSF protein, she successively developed various neurological signs, ie, bilateral external ophthalmoplegia, ataxia, hearing impairment, and severe depression, ptosis, myopathy, cardiomyopathy, and dysphagia, Muscle biopsy performed at 63 years of age showed numerous ragged-red fibers and multiple mtDNA deletions
-movement disorder (ataxia)
-ragged red fibers
-myopathy
-ptosis
-ophthalmoplegia
-external ophthalmoplegia
-dysphagia
adult
3063n/aEchaniz-Laguna et al, 2010;

[view data]

308A467T2
A467T2
progressive imbalance, hand and foot numbness, with impotence and dysarthria, progressive diplopia, bilateral ptosis with severe ophthalmoparesis in all directions and diplopia on lateral gaze. There was mild dysarthria and severe sensory ataxia, mild weakness in proximal and distal muscle groups, myopathy, multiple mtDNA deletions in muscle.
-movement disorder (ataxia)
-sensory ataxia
-myopathy
-ptosis
-PEO
-diplopia
-dysarthria
adult
4146n/aMcHugh et al, 2010;

[view data]

309A467T2
A467T2
progressive difficulty walking, hand and foot numbness, ataxia, dysarthria, ptosis, sensory ataxia, with progressive ophthalmoplegia, dysarthria, nystagmus, dysphagia. Dysarthria became evident from age 55 years, and she developed ptosis at 62 years.
-movement disorder (ataxia)
-sensory ataxia
-ptosis
-ophthalmoplegia
-dysphagia
-dysarthria
-nystagmus
adult
4262n/aMcHugh et al, 2010;

[view data]

311G848S1
A467T2
Cyclic vomiting, episodic hypoglycemia then seizure onset at 6 years, generalized seizures, GI dysmotility, eyelid ptosis,ophthalmoplegia, sensorineural hearning loss, absent smooth pursuit eye movements
-ptosis
-ophthalmoplegia
-GI dysmotility
-vomiting
-cyclic vomiting
-hypoglycemia
childhood
611n/aSaneto et al, 2010;

[view data]

314A467T2
A467T2
Elevated CSF protein, occipital stroke, visual field deficit, peripheral neuropathy, migraine, epilepsy, ataxia, myoclonus, progressive gait ataxia, ophthalmoplegia, dysarthria, dysphagia, valproate induced encephalopathy and depression
-myoclonic seizures
-epilepsy
-movement disorder (ataxia)
-peripheral neuropathy
-ophthalmoplegia
-stroke
-headache/ migraine
-encephalopathy
-dysphagia
-dysarthria
juvenile
1839n/aBrinjikji et al, 2011;

[view data]

315A467T2
A467T2
Hospitalized at age 7 for headache, fever, lethargy, and seizures, Elevated CSF protein, occipital stroke, visual field deficit, peripheral neuropathy, migraine, epilepsy, The patient began valproate therapy at age 11 and suffered hepatic encephalopathy which resolved after carnitine therapy.
-epilepsy
-peripheral neuropathy
-stroke
-headache/ migraine
-encephalopathy
childhood
728n/aBrinjikji et al, 2011;

[view data]

318G848S1
A467T2
Myoclonic Seizures, Epilepsia partialis continua, Developmental Delay or Regression, ataxia, Abnormal Liver Enzymes, Serum Lactate, liver mtDNA depletion, Alpers
-myoclonic seizures
-epilepsia partialis
-movement disorder (ataxia)
-developmental delay
-Alpers syndrome
-encephalopathy
infantile
0.5n/a3.33Hunter et al, 2011;

[view data]

319G848S1
A467T2
Myoclonic Seizures, Generalized tonic-clonic seizures, Focal motor seizures, Developmental Delay or Regression, hypotonia, tremor, Abnormal Liver Enzymes, Serum Lactate, liver mtDNA depletion, death by liver failure, Alpers
-myoclonic seizures
-liver failure
-hypotonic
-developmental delay
-Alpers syndrome
-tremor
-encephalopathy
-epilepsy
infantile
0.83n/a0.92Hunter et al, 2011;

[view data]

320A467T2
A467T2
Myoclonic Seizures, Focal motor seizures, Epilepsia partialis continua, Developmental Delay or Regression, Abnormal Liver Enzymes, Alpers
-myoclonic seizures
-epilepsia partialis
-developmental delay
-Alpers syndrome
-encephalopathy
childhood
5n/a10.83Hunter et al, 2011;

[view data]

321R852C1
A467T2
Myoclonic Seizures, visual disturbance, motor paresis, Focal motor seizures, Epilepsia partialis continua, Developmental Delay or Regression, ataxia, Serum Lactate, liver mtDNA depletion, Alpers
-myoclonic seizures
-epilepsia partialis
-movement disorder (ataxia)
-developmental delay
-Alpers syndrome
-encephalopathy
infantile
1.33n/a5.08Hunter et al, 2011;

[view data]

322S305R3
A467T2
Myoclonic Seizures, Focal motor seizures, Developmental Delay or Regression, visual disturbance, Multi-organ failure, pancreatitis Abnormal Liver Enzymes, Serum Lactate, liver mtDNA depletion, Alpers
-myoclonic seizures
-developmental delay
-pancreatitis
-Alpers syndrome
-encephalopathy
-epilepsy
childhood
3n/a3.67Hunter et al, 2011;

[view data]

323L966R1
A467T2
Generalized tonic-clonic seizures, Focal motor seizures, Epilepsia partialis continua, Developmental Delay or Regression, visual disturbance, Abnormal Liver Enzymes, liver mtDNA depletion, Alpers
-epilepsia partialis
-developmental delay
-Alpers syndrome
-encephalopathy
infantile
0.75n/a1.75Hunter et al, 2011;

[view data]

324L966R1
A467T2
Focal motor seizures, Epilepsia partialis continua, Developmental Delay or Regression, motor paresis, tremor Abnormal Liver Enzymes, Alpers
-epilepsia partialis
-developmental delay
-Alpers syndrome
-tremor
-encephalopathy
infantile
1.42n/a1.58Hunter et al, 2011;

[view data]

325R232H4
H277L3
A467T2
Developmental Delay or Regression, motor paresis, hypotonia, vomiting, Abnormal Liver Enzymes, Serum Lactate, liver mtDNA depletion, clinical diagnosis of infantile hepatopathy
-hypotonic
-developmental delay
-vomiting
infantile
0.17n/a0.25Hunter et al, 2011;

[view data]

326R232H4
H277L3
A467T2
Developmental Delay or Regression, hypotonia, vomiting, Abnormal Liver Enzymes, liver mtDNA depletion, clinical diagnosis of infantile hepatopathy
-hypotonic
-developmental delay
-vomiting
infantile
0.125n/a0.25Hunter et al, 2011;

[view data]

327L966R1
A467T2
focal seizures, elevated blood lactate, elevated liver enzymes, Elevated CSF protein, severe lactic acidosis, severe encephalopathy, Death occurred ten days after admission
-lactic acidosis
-focal seizures
-encephalopathy
infantile
1.42n/a1.42McCoy et al, 2011;

[view data]

328G848S1
A467T2
focal seizures, elevated liver transaminases, Elevated CSF protein, patient died several weeks later
-focal seizures
infantile
0.8n/a1McCoy et al, 2011;

[view data]

329R852C1
A467T2
clonic seizures of the right arm and leg, Coma persisted and was accompanied by hypoglycaemia, tachycardia and oliguria, CSF proteinwas elevated, cortical blindness, anarthria and profound hypotonia, Liver dysfunction, prolonged focal seizures, acute encephalopathy,
-focal seizures
-liver dysfunction
-hypotonic
-encephalopathy
-cortical blindness
infantile
1.75n/a3.5McCoy et al, 2011;

[view data]

330C418R1
A467T2
presented in status epilepticus, with a 24 h history of lethargy and vomiting, ataxia diagnosed at 17 months, diffuse encephalopathy,
-status epilepticus
-movement disorder (ataxia)
-encephalopathy
-vomiting
infantile
1.42n/a3.58McCoy et al, 2011;

[view data]

333A467T2
A467T2
Seizures, magnesium infusion stopped the seizures
-no known symptoms
juvenile
19n/an/aVisser et al, 2011;

[view data]

334A467T2
A467T2
Migraine, seizures, dysphasia, magnesium infusion stopped the seizures
-headache/ migraine
juvenile
17n/an/aVisser et al, 2011;

[view data]

338W748S5
A467T2
gait instability, manual coordination disorder, speech disturbance and secondary generalized motor seizures, tension-type headaches, complete external ophthalmoplegia, cerebellar dysarthria and ataxia, sensory ataxia in Romberg-testing, areflexia of the lower extremities, mild cognitive dysfunction, epileptic seizures, generalised cortical atrophy, sensory axonal neuropathy, dysarthria
-movement disorder (ataxia)
-sensory ataxia
-demyelinating neuropathy
-ophthalmoplegia
-external ophthalmoplegia
-headache/ migraine
-dysarthria
-areflexia
adult
2348n/aHansen et al, 2012;

[view data]

340C1188R1
A467T2
developmental delay, prolonged generalized seizure, hypotonia, epilepsia partialis continua, congestive heart failure, respiratory difficulty, autopsy showed enlarged and yellow liver, symmetrical but multifocal ischemic encephalopathy with laminar necrosis and neuronal degeneration in the cerebral cortex, Mitochondrial DNA copy number in blood was 43% of control values
-epilepsia partialis
-hypotonic
-encephalopathy
-developmental delay
-assumed Alpers
infantile
0.75n/a1.17Khan et al, 2012;

[view data]

341A467T2
W748S5
Diplopia, partial ophthalmoparesis in all directions of gaze and dysarthria, sensory neuropathy, COX-deficient fibers, multiple mtDNA deletions,
-PEO
-diplopia
-dysarthria
adult
n/a50n/aKinghorn et al, 2012;

[view data]

342A467T2
W748S5
Ataxia, dysarthria, suffered two generalized seizures, and developed severe progressive cognitive decline and psychiatric manifestations including visual and auditory hallucinations, bilateral external ophthalmoplegia, bilateral ptosis, and reduced visual acuities, bilateral sensorineural hearing loss, proximal muscle weakness in all four limbs and was areflexic, severe sensory neuropathy and myopathy,
-movement disorder (ataxia)
-muscle weakness
-myopathy
-ptosis
-ophthalmoplegia
-external ophthalmoplegia
-dysarthria
-hearing loss
juvenile
n/a1865Kinghorn et al, 2012;

[view data]

344A467T2
W748S5
ataxia, sensory neuropathy, dysarthria, and external ophthalmoparesis
-movement disorder (ataxia)
-PEO
-dysarthria
adult
3050n/aPelayo-Negro et al, 2012;

[view data]

345G848S1
A467T2
presented with hypoglycemia, lactic acidosis, moderate ketosis and liver dysfunction, generalized hypotonia, progressive jaundice and abdominal distension with ascites, status epilepticus with generalized tonico-clonic seizures. She had an intermittent tremor, moderate truncal ataxia with a wide-based gait, myoclonic seizures, epilepsia partialis continua,
-lactic acidosis
-status epilepticus
-myoclonic seizures
-epilepsia partialis
-movement disorder (ataxia)
-liver dysfunction
-jaundice
-hypotonic
-ketosis
-hypoglycemia
-tremor
infantile
0.29n/a5Scalais et al, 2012;

[view data]

348A467T2
A467T2
ptosis, PEO, muscle weakness, fatigability, peripheral neuropathy, ataxia, lactic acidosis and diarrhea alternating with constipation, ragged-red fibers,
-lactic acidosis
-movement disorder (ataxia)
-peripheral neuropathy
-ragged red fibers
-muscle weakness
-ptosis
-PEO
-diarrhea
adult
n/a46n/aTang et al, 2012;

[view data]

355R1096C3
A467T2
CPEO, Ptosis, Peripheral neuropathy, COX-deficient fibers, ragged red fibers, presence of mitochondrial dna deletions in muscle, Sensory and motor neuronopathy, Distal and proximal neurogenic change
-peripheral neuropathy
-ragged red fibers
-ptosis
-PEO
juvenile
1742n/aLax et al, 2012a;

[view data]

356A467T2
A467T2
CPEO, Ptosis, Peripheral neuropathy, COX-deficient fibers, ragged red fibers, presence of mitochondrial dna deletions in muscle, Sensory and motor neuronopathy, Distal neurogenic change, proximal myopathy.
-peripheral neuropathy
-ragged red fibers
-myopathy
-ptosis
-PEO
juvenile
1836n/aLax et al, 2012a;

[view data]

360W748S5
A467T2
CPEO, Ptosis, Peripheral neuropathy, COX-deficient fibers, ragged red fibers, presence of mitochondrial dna deletions in muscle, Severe sensory and moderate motor neuronopathy, Distal neurogenic change, proximal myopathy
-peripheral neuropathy
-ragged red fibers
-myopathy
-ptosis
-PEO
adult
3447n/aLax et al, 2012a;

[view data]

361A467T2
A467T2
CPEO, Ptosis, Peripheral neuropathy, COX-deficient fibers, presence of mitochondrial dna deletions in muscle, Severe sensory and moderate motor neuronopathy, Distal and proximal neurogenic change,
-peripheral neuropathy
-ptosis
-PEO
adult
4144n/aLax et al, 2012a;

[view data]

362W748S5
A467T2
CPEO, Ptosis, Peripheral neuropathy, COX-deficient fibers, presence of mitochondrial dna deletions in muscle, ataxia, Severe sensory, moderate motor axonal neuronopathy, Distal neurogenic, proximal myopathy
-movement disorder (ataxia)
-peripheral neuropathy
-myopathy
-ptosis
-PEO
adult
4148n/aLax et al, 2012a;

[view data]

363W748S5
A467T2
Peripheral neuropathy, ataxia, epilepsy, COX-deficient fibers, presence of mitochondrial dna deletions in muscle, Moderate sensory neuronopathy
-epilepsy
-movement disorder (ataxia)
-peripheral neuropathy
juvenile
1618n/aLax et al, 2012a;

[view data]

364W748S5
A467T2
Peripheral neuropathy, ataxia, epilepsy, presence of mitochondrial dna deletions in muscle,
-epilepsy
-movement disorder (ataxia)
-peripheral neuropathy
adult
2024n/aLax et al, 2012a;

[view data]

382A467T2
A467T2
Presented with migraine like headaches, ataxia, epilepsy, status epilepticus, nystagmus, myoclonus, neuropathy
-status epilepticus
-myoclonic seizures
-epilepsy
-movement disorder (ataxia)
-headache/ migraine
-nystagmus
juvenile
1520n/aTzoulis et al, 2006;

[view data]

383W748S5
E1143G
A467T2
Presented with epilepsy, headaches, epilepsy, status epilepticus, headaches, nystagmus, and neuropathy. Sodium valproate treatment for 2 months then stopped 2 months prior to death. Liver dysfunction, liver transplant 1 month prior to death, cause of death liver failure. Hepatic histology showed acute liver necrosis.
-status epilepticus
-epilepsy
-liver failure
-liver dysfunction
-headache/ migraine
-nystagmus
adult
20n/a20Tzoulis et al, 2006;

[view data]

384W748S5
E1143G
A467T2
Presented with progressive gait unsteadiness, ataxia, headaches, neuropathy, PEO ptosis onset age 25
-movement disorder (ataxia)
-ptosis
-PEO
-headache/ migraine
adult
2443n/aTzoulis et al, 2006;

[view data]

385W748S5
E1143G
A467T2
Presented with epilepsy, ataxia, status epilepticus, headaches, myoclonus, neuropathy. Sodium valproate treatment for 8 months. Stopped just prior to death. Liver dysfunction, cause of death liver failure. Hepatic histology showed acute liver necrosis.
-status epilepticus
-myoclonic seizures
-epilepsy
-movement disorder (ataxia)
-liver failure
-liver dysfunction
-headache/ migraine
childhood
10n/a10Tzoulis et al, 2006;

[view data]

386W748S5
E1143G
A467T2
Presented with epilepsy and headaches, ataxia, status epilepticus, nystagmus, myoclonus, neuropathy. Sodium valproate treatment 6 weeks prior to death. Liver dysfunction, cause of death status epilepticus and liver failure. Hepatic histology showed acute liver necrosis.
-status epilepticus
-myoclonic seizures
-epilepsy
-movement disorder (ataxia)
-liver failure
-liver dysfunction
-headache/ migraine
-nystagmus
juvenile
19n/a19Tzoulis et al, 2006;

[view data]

387W748S5
E1143G
A467T2
Presented with progressive gait unsteadiness, ataxia, headaches, myoclonus, neuropathy, PEO, ptosis onset at age 44
-myoclonic seizures
-movement disorder (ataxia)
-ptosis
-PEO
-headache/ migraine
adult
3650n/aTzoulis et al, 2006;

[view data]

388W748S5
E1143G
A467T2
Presented with epilepsy, status epilepticus, headaches, nystagmus, myoclonus, neuropathy. Sodium valproate treatment 7 weeks prior to death. Liver dysfunction and rising liver enzymes and bilirubin terminally, cause of death status epilepticus. Hepatic histology showed centrolobular degeneration.
-status epilepticus
-myoclonic seizures
-epilepsy
-liver dysfunction
-headache/ migraine
-nystagmus
juvenile
15n/a21Tzoulis et al, 2006;

[view data]

389W748S5
E1143G
A467T2
Presented with epilepsy and headaches, ataxia, epilepsy, status epilepticus, myoclonus, neuropathy. Sodium valproate treatment 7 weeks prior to death. Liver dysfunction and rising liver enzymes and bilirubin terminally, cause of death status epilepticus. Hepatic histology showed centrolobular degeneration.
-status epilepticus
-myoclonic seizures
-epilepsy
-movement disorder (ataxia)
-liver dysfunction
-headache/ migraine
juvenile
14n/a23Tzoulis et al, 2006;

[view data]

402A467T2
W748S5
K561M2
Feeding difficulties 2 days after birth and trunk hypotonia, dysmorphy, hypotonia, coloboma, heart failure at 2 months, liver insufficiency at 4 months. Liver and muscle mtDNA depletion.
-liver failure
-hypotonic
infantile
0.001n/a0.5Sarzi et al, 2007;

[view data]

408G848S1
A467T2
Delayed motor and mental development, From the age of 3 years his psychomotor development declined and epilepsy, visual impairment and sensorineuronal deafness, epilepsia partialis continua. Bilateral ptosis, generalized hypotonia, ataxia, absent reflexes and hyperlaxity by age 5.
-epilepsy
-epilepsia partialis
-movement disorder (ataxia)
-ptosis
-hypotonic
infantile
35n/ade Vries et al, 2008;

[view data]

409A467T2
at age 24 developed PEO and weakness of neck and proximal limb muscles. presence of multiple mtDNA deleted species, unsteady, broad-based gait. At age 32 she had complete PEO, bradykinesia, cogwheel rigidity, slurred speech, dysphagia, dysmetria, positive Romberg sign, reduced arm swing, and intermittent bilateral postural-action tremor. axonal sensorimotor neuropathy, severe depression, insomnia, and nocturnal panic attacks Has also mutation ANT1 gene (V289M)
-axonal sensorimotor polyneuropathy
-PEO
-dysphagia
-tremor
adult
2442n/aGalassi et al, 2008;

[view data]

411Q879H1
E1143G
A467T2
T885S1
Presented with epilepsy following minor head trauma, 2 months after valproate treatment developed persistent vomiting and encephalopathy, deranged liver function tests, prolonged clotting, elevated ammonia, and a high plasma lactate, Hepatic dysfunction progressed,
-epilepsy
-encephalopathy
-vomiting
infantile
2n/an/aMcFarland et al, 2008;

[view data]

412A467T2
W748S5
episodic headache, cognitive decline, and seizures, repeatedly resulting in generalized status epilepticus, ataxia, sensorimotor peripheral neuropathy, dysarthria, PEO with diplopia, mild bilateral ptosis, epilepsy, cognitive impairment, myoclonus,
-status epilepticus
-myoclonic seizures
-epilepsy
-movement disorder (ataxia)
-peripheral neuropathy
-ptosis
-PEO
-diplopia
-headache/ migraine
-dysarthria
adult
2839n/aPaus et al, 2008;

[view data]

413A467T2
W748S5
E1143G
Presented with PEO, mild bilateral ptosis, dysarthria, ataxia, and neuropathy
-movement disorder (ataxia)
-ptosis
-PEO
-dysarthria
adult
3637n/aPaus et al, 2008;

[view data]

419M919T1
A467T2
Peripheral neuropathy, PEO, ataxia
-movement disorder (ataxia)
-peripheral neuropathy
-PEO
adult
2341n/aAmiot et al, 2009;

[view data]

423A467T2
A467T2
Presented with status epilepticus, cerebellar ataxia and myoclonus, epilepsia partialis continua, Transient liver dysfunction with sodium valproate treatment at age 15, refractory focal motor status at age 17,
-status epilepticus
-myoclonic seizures
-epilepsia partialis
-cerebellar ataxia
-movement disorder (ataxia)
-liver dysfunction
childhood
5n/a17Boes et al, 2009;

[view data]

429A467T2
LS-like, sensorimotor neuropathy. At 56 years old, patient 13 developed a motor neuron disease with severe tetraparesis, dysphonia and respiratory insufficiency leading to death a few years later. Muscular biopsy was strongly evocative of mitochondrial disease with a generalized RC deficiency, multiple mtDNA deletions and decreased mtDNA copy number in the muscle (39%).
-respiratory deficiency
adult
565660Rouzier et al, 2013;

[view data]

439W748S5
A467T2
R-EPC (refractory epilepsia partialis continua), axonal neuropathy, cerebellar ataxia, hyperintensity of rolandic, occipital and cerebellar cortex and dentate nucleus.
-epilepsia partialis
-cerebellar ataxia
-movement disorder (ataxia)
-demyelinating neuropathy
juvenile
17n/an/aRouzier et al, 2013;

[view data]

445T914P1
A467T2
myoclonic status epilepticus, myoclonic seizures at 8 months, developmental regression, febrile upper respiratory tract infection, nearly continuous myoclonic jerks, normocephalic, nondysmorphic, diffuse hypotonia, died secondary to complications of hepatic failure.
-status epilepticus
-myoclonic seizures
-liver failure
-hypotonic
infantile
0.8n/a1Dhamija et al, 2011;

[view data]

447G848S1
A467T2
Alpers, status epilepticus and somnolence, ataxia with dysmetria and muscular hypotonia. Healthy unrelated parents. Laboratory investigations revealed myoclonic epilepsy with ragged red fibers,
-status epilepticus
-epilepsy
-movement disorder (ataxia)
-ragged red fibers
-hypotonic
-Alpers syndrome
-encephalopathy
-developmental delay
infantile
2.23.55.5Hasselmann et al, 2010;

[view data]

455A467T2
W748S5
E1143G
Ataxic sensory neuropathy, dysarthria, progressive ophthalmoplegia, paresthesia of lower extremities, unsteady gait, slurred speech, absent deep tendon reflexes, vibrations, ataxic gait and positive Romberg sign. Multiple mtDNA deletions, a marked decrease in mtDNA copy number.
-movement disorder (ataxia)
-ophthalmoplegia
-dysarthria
adult
3747n/aPosada et al, 2010;

[view data]

456W748S5
A467T2
Focal parieto-occipital lobe seizures, migraine headaches, cerebellar ataxia, sensory–motor axonal neuropathy, and impairment of visual perception and cognitive function.
-cerebellar ataxia
-movement disorder (ataxia)
-demyelinating neuropathy
-headache/ migraine
juvenile
1516n/aRoshal et al, 2011;

[view data]

459W748S5
A467T2
abnormal gait, ataxia, PEO, and jerky torticollis, mild cerebellar atrophy, sensory neuronopathy.
-movement disorder (ataxia)
-cerebellar atrophy
-PEO
adult
4345n/aTuladhar et al, 2013;

[view data]

460A467T2
A467T2
Epilepsy, stroke-like episodes, ataxia, peripheral neuropathy, progressive external ophthalmoplegia (PEO).
-epilepsy
-movement disorder (ataxia)
-peripheral neuropathy
-PEO
-ophthalmoplegia
-external ophthalmoplegia
-stroke
-stroke-like episodes
juvenile
16n/a53Tzoulis et al, 2013;

[view data]

461A467T2
A467T2
Epilepsy, ataxia, peripheral neuropathy, progressive external ophthalmoplegia (PEO).
-epilepsy
-movement disorder (ataxia)
-peripheral neuropathy
-PEO
-ophthalmoplegia
-external ophthalmoplegia
juvenile
1542n/aTzoulis et al, 2013;

[view data]

468W748S5
A467T2
Ataxia, peripheral neuropathy, progressive external ophthalmoplegia (PEO).
-movement disorder (ataxia)
-peripheral neuropathy
-PEO
-ophthalmoplegia
-external ophthalmoplegia
adult
3658n/aTzoulis et al, 2013;

[view data]

469W748S5
A467T2
Ataxia, peripheral neuropathy, progressive external ophthalmoplegia (PEO).
-movement disorder (ataxia)
-peripheral neuropathy
-PEO
-ophthalmoplegia
-external ophthalmoplegia
adult
2450n/aTzoulis et al, 2013;

[view data]

470G848S1
A467T2
Epilepsy, stroke-like episodes.
-epilepsy
-stroke
-stroke-like episodes
infantile
0.6n/a0.6Tzoulis et al, 2013;

[view data]

504A467T2
A467T2
Ataxia, ptosis, pareses, sensory neuropathy, motor neuropathy, axonal neuropathy
-movement disorder (ataxia)
-demyelinating neuropathy
-ptosis
adult
3840n/aHanisch et al, 2014;

[view data]

505W748S5
A467T2
Ataxia, ptosis, pareses, diabetes, sensory neuropathy, motor neuropathy, axonal neuropathy, demyelinating neuropathy.
-movement disorder (ataxia)
-demyelinating neuropathy
-ptosis
adult
4956n/aHanisch et al, 2014;

[view data]

506W748S5
A467T2
Ataxia, ptosis, mild cognitive impairment, sensory neuropathy, motor neuropathy, axonal neuropathy, demyelinating neuropathy.
-movement disorder (ataxia)
-demyelinating neuropathy
-ptosis
adult
4145n/aHanisch et al, 2014;

[view data]

507R627Q5
A467T2
Ataxia, ptosis, myalgia, sensory neuropathy, motor neuropathy, axonal neuropathy, demyelinating neuropathy.
-movement disorder (ataxia)
-demyelinating neuropathy
-ptosis
adult
4650n/aHanisch et al, 2014;

[view data]

516W748S5
A467T2
Ataxia, Epilepsy, Dementia, Encephalopathy, Myoclonus, Fatigue, Depression, Dysarthria, Cardiac failure, cardiomyopathy, Diabetes, arPEO, Ischemic heart disease.
-myoclonic seizures
-epilepsy
-movement disorder (ataxia)
-myopathy
-PEO
-encephalopathy
-dementia
-dysarthria
adult
2024n/aLax et al, 2012b;

[view data]

521G848S1
A467T2
Alpers, Epilepsy, developmental delay, COX deficient fibres.
-epilepsy
-developmental delay
-Alpers syndrome
-encephalopathy
infantile
1n/an/aStewart et al, 2009;

[view data]

522A467T2
A467T2
Alpers, Encephalopathy, liver failure.
-liver failure
-encephalopathy
-Alpers syndrome
-developmental delay
-epilepsy
infantile
1n/an/aStewart et al, 2009;

[view data]

529G848S1
A467T2
mtDNA depletion. severe hypoglycemia, liver biopsy shows micronodular cirrhosis. At 3 y 9 m, status epilepticus develops which occurs again at 4 y and is difficult to control. myoclonia. She dies from bronchopulmonary infection when 5 y old. COX negative fibers.
-status epilepticus
-hypoglycemia
infantile
0.2545Roels et al, 2009;

[view data]

536S1104F1
A467T2
Epilepsy, Ataxia, Myopathy.
-epilepsy
-movement disorder (ataxia)
-myopathy
childhood
n/a5n/aSitarz et al, 2014;

[view data]

537W748S5
A467T2
Ataxia, neuropathy, PEO, MIRAS.
-movement disorder (ataxia)
-PEO
adult
n/a39n/aSitarz et al, 2014;

[view data]

539A467T2
W748S5
E1143G
Started as an ataxic syndrome, Alpers, ragged red fibers, COX-deficient fibers, mtDNA deletions. mtDNA copy numbers 1.6 fold. She was healthy and developed normally until her late preschool years when she developed slowly progressive ataxia. Occasional myoclonic seizures, and at 13 years of age, valproate treatment was started because of occipital seizures. ataxia, dementia, and cortical blindness. She developed refractory seizures, including multifocal EPC, status epilepticus, and myoclonus.
-status epilepticus
-myoclonic seizures
-intractable seizure
-movement disorder (ataxia)
-ragged red fibers
-dementia
-cortical blindness
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
childhood
51314Kollberg et al, 2006;

[view data]

540R574W2
A467T2
The girl was healthy and developed normally until one year of age when, during a mild respiratory infection, she had repeated multifocal partial seizures with clonic jerking and unconsciousness. The episode was later followed by the development of muscular hypotonia and of myoclonus. Mild psychomotor regression, ataxia, and slightly elevated serum transaminases were noticed. At 3 years of age, a mild infection provoked a prolonged status epilepticus, which lasted 3 weeks and included stroke-like features and rightsided hemiparesis. This was followed by a progressive deterioration of cognitive and motor functions and the development of ptosis and external ophthalmoplegia. Alpers. Febrile infections provoked repetitive status epilepticus with seizures in the form of migrating epilepsia partialis continua. mtDNA Deletions.
-status epilepticus
-myoclonic seizures
-hemiparesis
-epilepsia partialis
-movement disorder (ataxia)
-ptosis
-ophthalmoplegia
-external ophthalmoplegia
-stroke
-hypotonic
-Alpers syndrome
-encephalopathy
-developmental delay
infantile
11.54.333Kollberg et al, 2006;

[view data]

541R574W2
A467T2
mtDNA Deletions. She was healthy until 7 months of age when she, in association with pyelonephritis, had onset of myoclonic seizures and weakness of the left arm and leg. leftsided myoclonic seizures progressing to status epilepticus in the form of migrating EPC and unconsciousness. pneumonia and colitis.
-status epilepticus
-myoclonic seizures
infantile
0.58311.166Kollberg et al, 2006;

[view data]

542G848S1
A467T2
Ragged Red Fibers, COX-Deficient Fibers. The boy had feeding difficulties with failure to thrive since 3 months of age. Delayed motor development. general muscle weakness and ataxia. compromised liver function.
-movement disorder (ataxia)
-ragged red fibers
-muscle weakness
-failure to thrive
infantile
0.33n/a1.33Kollberg et al, 2006;

[view data]

544G303R3
A467T2
Psychomotor deterioration, hypotonia, spasticity, Stroke-like episodes, Refractory seizures, Epilepsia Partialis Continua, Status Epilepticus, Myoclonus, severe hepatic dysfunction,
-status epilepticus
-myoclonic seizures
-intractable seizure
-epilepsia partialis
-spasticity
-stroke
-hypotonic
-stroke-like episodes
infantile
0.916n/an/aSofou et al, 2012;

[view data]

545A467T2
A467T2
Epilepsy, stroke-like episode, Ataxia, Neuropathy, PEO
-epilepsy
-movement disorder (ataxia)
-PEO
-stroke
juvenile
15n/a44Tzoulis et al, 2014;

[view data]

546A467T2
A467T2
Epilepsy, stroke-like episode, Ataxia, Neuropathy, PEO
-epilepsy
-movement disorder (ataxia)
-PEO
-stroke
childhood
8n/a47Tzoulis et al, 2014;

[view data]

547A467T2
A467T2
Epilepsy, stroke-like episode, Ataxia, Neuropathy, PEO
-epilepsy
-movement disorder (ataxia)
-PEO
-stroke
juvenile
16n/a53Tzoulis et al, 2014;

[view data]

555W748S5
A467T2
Epilepsy, stroke-like episode, Ataxia, Neuropathy.
-epilepsy
-movement disorder (ataxia)
-stroke
juvenile
14n/a23Tzoulis et al, 2014;

[view data]

556W748S5
A467T2
Epilepsy, stroke-like episode, Ataxia, Neuropathy.
-epilepsy
-movement disorder (ataxia)
-stroke
juvenile
13n/a21Tzoulis et al, 2014;

[view data]

557G303R3
A467T2
Epilepsy, stroke-like episode.
-epilepsy
-stroke
infantile
0.9n/a1.1Tzoulis et al, 2014;

[view data]

558G303R3
A467T2
Epilepsy, stroke-like episode, Ataxia.
-epilepsy
-movement disorder (ataxia)
-stroke
infantile
2n/a8Tzoulis et al, 2014;

[view data]

559G848S1
A467T2
Epilepsy, stroke-like episode.
-epilepsy
-stroke
infantile
0.6n/a0.6Tzoulis et al, 2014;

[view data]

569L304R3
A467T2
psychiatric symptoms, ptosis, opthalmoplegia, dysphonia, dysphagia, muscle weakness, loss of weight, areflexia.
-muscle weakness
-ptosis
-PEO
-dysphagia
-areflexia
juvenile
1628n/aVan Goethem et al, 2001;

[view data]

570L304R3
A467T2
ocular symptoms, psychiatric symptoms, ptosis, opthalmoplegia, muscle weakness, distal sensory neuropathy, areflexia, pes cavus.
-muscle weakness
-ptosis
-PEO
-areflexia
adult
2538n/aVan Goethem et al, 2001;

[view data]

571L304R3
A467T2
ocular symptoms, ptosis, opthalmoplegia, dysphagia, muscle weakness, areflexia, retinopathy.
-muscle weakness
-ptosis
-PEO
-dysphagia
-areflexia
adult
2434n/aVan Goethem et al, 2001;

[view data]

572R3P
A467T2
ptosis, opthalmoplegia, dysphonia, dysphagia, muscle weakness, loss of weight, distal sensory neuropathy, areflexia.
-muscle weakness
-ptosis
-PEO
-dysphagia
-areflexia
adult
2061n/aVan Goethem et al, 2001;

[view data]

573R3P
A467T2
ptosis, opthalmoplegia, dysphonia, dysphagia, distal sensory neuropathy, areflexia.
-ptosis
-PEO
-dysphagia
-areflexia
adult
3058n/aVan Goethem et al, 2001;

[view data]

579A467T2
A467T2
early-onset ataxia, epilepsy, sensory neuropathy.
-epilepsy
-movement disorder (ataxia)
childhood
12.5n/an/aSchicks et al, 2010;

[view data]

589A467T2
A467T2
This man developed epilepsy at age 5. At age 16 he developed unsteadiness and was euphoric. He had a right-sided divergent squint and difficulties on upgaze when the right eye would drift outward. Eye movements were otherwise full. There were horizontal nystagmus, absent tendon reflexes, and loss of proprioception distally in the legs. His gait was ataxic. Positive Romberg sign. At age 20 mild dysarthria was noted. Subsequently, he developed finger dysmetria, dysdiadochokinesis and myoclonus involving his arms, diarrhea, weight loss and cachexia, and ophthalmoplegia. Between the ages of 35 and 54 years he had infrequent seizures, but at age 55 he developed treatment-resistant status epilepticus and died. Cognitive dysfunction, axonal neuropathy, status epilepticus.
-status epilepticus
-myoclonic seizures
-epilepsy
-demyelinating neuropathy
-ophthalmoplegia
-diarrhea
-dysarthria
-nystagmus
childhood
5n/a55Winterthun et al, 2005;

[view data]

590A467T2
A467T2
At age 17, she had an epileptic seizure preceded by tiredness and blurred vision. Visual blurring and poor memory persisted and 5 days later she developed status epilepticus with a focal start in the right arm. Examination showed horizontal nystagmus that did not settle, normal eye movements, and normal peripheral findings except that the deep tendon reflexes were recorded as weak. She returned 3 years later at age 20 with headache and unsteadiness. myoclonus and progressive ophthalmoplegia, ataxia, frequent myoclonic jerks. Cognitive dysfunction, axonal neuropathy.
-status epilepticus
-myoclonic seizures
-movement disorder (ataxia)
-demyelinating neuropathy
-ophthalmoplegia
-headache/ migraine
-nystagmus
juvenile
1749n/aWinterthun et al, 2005;

[view data]

591A467T2
A467T2
Headache, tremor. At age 20, he developed unsteadiness and dizziness. Examination showed upper limb tremor and myoclonus, and titubation. At age 31 limitation of horizontal eye movements was recorded; muscle biopsy was reported as showing no ragged red fibers. Subsequently, he developed limb and truncal ataxia, worsening ophthalmoplegia, pain in his extremities with glove and stocking sensory loss, particularly affecting proprioception, and sudden falls with altered consciousness that responded to anticonvulsant treatment. Sensory ataxia. axonal neuropathy, ophthalmoplegia, demyelination neuropathy, cognitive dysfunction, focal occipital epilepsy.
-myoclonic seizures
-epilepsy
-movement disorder (ataxia)
-sensory ataxia
-demyelinating neuropathy
-ragged red fibers
-ophthalmoplegia
-headache/ migraine
-tremor
childhood
1043n/aWinterthun et al, 2005;

[view data]

592A467T2
A467T2
Headache, tremor, sensory ataxia, dysarthria, nystagmus, ophthalmoplegia, cognitive dysfunction, axonal neuropathy, demyelinating neuropathy. She had headaches with preceding visual symptoms diagnosed as migraine that started at age 16. Episodic, involuntary jerking movements involving head and hands developed soon after. At age 18 she had two tonic clonic seizures preceded by poor concentration, confusion, and increased involuntary movements. Examination recorded titubation and myoclonus of the arms diminished reflexes in the legs, and reduced proprioception at the hallux. She has recurrent seizures and frequent headaches. At age 26 cerebellar and sensory ataxia, dysarthria, limita- tion of horizontal and vertical eye movements, and absent reflexes were recorded. COX negative fibers. At age 37 she was admitted with status epilepticus preceded by headache and visual symptoms in the right visual field. She remains ataxic but ambulant with assistance.
-status epilepticus
-myoclonic seizures
-movement disorder (ataxia)
-sensory ataxia
-demyelinating neuropathy
-ophthalmoplegia
-headache/ migraine
-dysarthria
-nystagmus
-tremor
juvenile
1639n/aWinterthun et al, 2005;

[view data]

611Splice site
mutation:
IVS20nt+2T>C
A467T2
Seizures, Alpers syndrome, Jaundice at 9 months and liver enlargement.
-jaundice
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
infantile
0.66n/an/aSarzi et al, 2007;

[view data]

612Frameshift:
c.975_976insCT326fsX387
A467T2
Myoclonus epilepsy, Epilepsy, Alpers syndrome, steatosis, death at 3 years
-myoclonic seizures
-epilepsy
-Alpers syndrome
-encephalopathy
-developmental delay
childhood
3n/a3Sarzi et al, 2007;

[view data]

613A467T2
A467T2
at 18 year of age, he hadstatus epilepticus lasting 8 days, followed by a “Todd paralysis” of the left arm and face. Five years later, he had an acute psychiatric illness, hyperventilation, gastrointestinal symptoms, gait unsteadiness, and disturbed limb coordination. Between 32 and 35 years of age, he lost 13 kg of weight. On exami- nation, he had sensory gait ataxia, limb ataxia, areflexia, generalized dystrophy, and loss of vibration and static joint position sense at the distal lower limbs, severe dysarthria, and a left-sided Babinski sign. Romberg test was positive. intestinal pseudo-obstruction, anorexia, and further weight loss. A few weeks later, he developed stupor (Glasgow coma scale, 5/15), hyperventilation, myoclonic jerks, and seizures necessitating intensive care and artificial ventilation. gastroparesis. dilated cardiomyopathy.
-status epilepticus
-movement disorder (ataxia)
-myopathy
-paralysis
-GI dysmotility
-dysarthria
-areflexia
juvenile
18n/a39Van Goethem et al, 2004;

[view data]

614A467T2
A467T2
Increasing gait unsteadiness, mild cognitive decline in the fifth decade. Cataracts. ataxic gait. Deep tendon reflexes were absent. Vibration and position sense were absent at the lower limbs early on, whereas light touch sensation was decreased at a later stage. Pes Cavus. gaze paresis, nystagmus. axonal generalized peripheral neuropathy. brainstem dysfunction.
-movement disorder (ataxia)
-peripheral neuropathy
-nystagmus
juvenile
n/a49n/aVan Goethem et al, 2004;

[view data]

615A467T2
A467T2
Increasing gait unsteadiness. ataxic gait. Deep tendon reflexes were absent. Vibration and position sense were absent at the lower limbs early on, whereas light touch sensation was decreased at a later stage. Pes Cavus. Dysarthria. horizontal and vertical gaze-evoked nystagmus. axonal generalized peripheral neuropathy. brainstem dysfunction.
-movement disorder (ataxia)
-peripheral neuropathy
-dysarthria
-nystagmus
juvenile
n/a47n/aVan Goethem et al, 2004;

[view data]

616W748S5
E1143G
A467T2
minor tremor of the hands from age 12 years. In his late 20s, he experienced tingling in both hands, followed by tingling in the legs. In the early fourth decade, he became unsteady at walking, especially in the dark. From his early 40s, his speech became slurred (dysarthria). On examination at age 52 years, he had an ataxic gait, and Romberg test was positive. There was dysarthria and bilateral ophthalmoparesis. generalized areflexia.
-movement disorder (ataxia)
-PEO
-dysarthria
-areflexia
-tremor
childhood
1252n/aVan Goethem et al, 2004;

[view data]

618A467T2
T251I
P587L2
diabetes mellitus 2, congestive heart failure, hypothyroidism, hypertension, depression with psychotic features and gastric bypass surgery. gait difficulties, cognitive impairment, ophthalmoplegia, resting tremor and peripheral neuropathy. Shooting pains and numbness in her lower extremities, occasional rectal incontinence. Presyncopal dizziness. Complicated diabetic retinopathy. sensory ataxia secondary to a sensorimotor polyneuropathy, chronic supranuclear ophthalmoplegia, and a resting tremor of her right hand. bilateral ptosis and marked temporal muscle wasting. Her sensory examination found loss of pinprick sensation, temperature and vibration bilaterally up to her hips. She had bilateral vibration loss at her fingertips. She had loss of proprioception at her toes. She had bilateral dysdiadochokinesia with significant ataxia on finger to nose testing. Arreflexic in her lower extremities. On cognitive testing she was found to have moderate dementia with significant deficits in registration and construction as well as ideomotor apraxia.
-movement disorder (ataxia)
-sensory ataxia
-peripheral neuropathy
-polyneuropathy
-axonal sensorimotor polyneuropathy
-ptosis
-ophthalmoplegia
-dementia
-hypothyroidism
-tremor
adult
5560n/aLovan et al, 2013;

[view data]

623Splice site
mutation:
c.2157+5_+6gc>ag
A467T2
Alpers, stroke, hypotonia, Dementia, developmental delay, seizures.
-stroke
-hypotonic
-developmental delay
-dementia
-Alpers syndrome
-encephalopathy
-epilepsy
infantile
1n/an/aWong et al, 2008;

[view data]

624Q1236H
Frameshift:
p.T849H(insC)fs868X
A467T2
Alpers, chorea, microcephaly, leukodystrophy, Seizures, Dementia, developmental delay.
-developmental delay
-dementia
-Alpers syndrome
-microcephaly
-encephalopathy
-epilepsy
infantile
1.5n/an/aWong et al, 2008;

[view data]

627Q497H2
W748S5
E1143G
A467T2
Hearing loss, Ataxia Neuropathy Spectrum, Seizures, dementia, developmental delay
-movement disorder (ataxia)
-developmental delay
-dementia
-hearing loss
juvenile
17n/an/aWong et al, 2008;

[view data]

629G848S1
A467T2
Developmental delay, dementia, seizures, Alpers, Ataxia
-movement disorder (ataxia)
-developmental delay
-dementia
-Alpers syndrome
-encephalopathy
-epilepsy
infantile
2n/an/aWong et al, 2008;

[view data]

630G848S1
A467T2
Developmental delay, dementia, seizures, Alpers, Lactic acidosis, Stroke
-lactic acidosis
-stroke
-developmental delay
-dementia
-Alpers syndrome
-encephalopathy
-epilepsy
infantile
2n/an/aWong et al, 2008;

[view data]

631G848S1
A467T2
Developmental delay, dementia, seizures, Alpers, Lactic acidosis, Cortical athrophy, hypoglycemia
-lactic acidosis
-developmental delay
-dementia
-Alpers syndrome
-hypoglycemia
-encephalopathy
-epilepsy
infantile
1.5n/an/aWong et al, 2008;

[view data]

632G848S1
A467T2
Developmental delay, dementia, seizures, Alpers, Stroke, ataxia, exercise intolerance
-movement disorder (ataxia)
-exercise intolerance
-stroke
-developmental delay
-dementia
-Alpers syndrome
-encephalopathy
-epilepsy
childhood
9n/an/aWong et al, 2008;

[view data]

633G848S1
A467T2
Developmental delay, dementia, seizures, Alpers, hypotonia, failure to thrive
-failure to thrive
-hypotonic
-developmental delay
-dementia
-Alpers syndrome
-encephalopathy
-epilepsy
infantile
0.8n/an/aWong et al, 2008;

[view data]

634G848S1
A467T2
Developmental delay, dementia, seizures, Alpers
-developmental delay
-dementia
-Alpers syndrome
-encephalopathy
-epilepsy
infantile
2n/an/aWong et al, 2008;

[view data]

635Frameshift:
p.L424GfsX28
A467T2
Developmental delay, dementia, seizures, Alpers, Family history of acute liver failure
-liver failure
-developmental delay
-dementia
-Alpers syndrome
-encephalopathy
-epilepsy
infantile
1n/an/aWong et al, 2008;

[view data]

636Nonsense
mutation:
Q68X
A467T2
Developmental delay, dementia, seizures, Alpers, Ptosis, ataxia, visual hallucinations
-movement disorder (ataxia)
-ptosis
-developmental delay
-dementia
-Alpers syndrome
-encephalopathy
-epilepsy
childhood
3n/an/aWong et al, 2008;

[view data]

637Nonsense
mutation:
Q715X
A467T2
Developmental delay, dementia, seizures, Alpers
-developmental delay
-dementia
-Alpers syndrome
-encephalopathy
-epilepsy
childhood
4n/an/aWong et al, 2008;

[view data]

638T914P1
A467T2
Developmental delay, dementia, seizures, Alpers
-developmental delay
-dementia
-Alpers syndrome
-encephalopathy
-epilepsy
infantile
2n/an/aWong et al, 2008;

[view data]

645Nonsense
mutation:
E873X
A467T2
Nonsense
mutation:
E873X
His speech and motor development were normal until 19 months of age when he developed an episode of encephalopathy, ataxia, and hypertonia associated with an acute febrile illness. At 30 months, he developed a refractory focal myoclonic seizure disorder. His terminal admission was associated with a documented Rotavirus infection. At this time, he was noted to have cortical blindness, epilepsia partialis continua, and acute liver failure (hepatic failure). lactic acidemia. He was well until 19 months of age, when he experienced an acute febrile illness with anorexia, vomiting, and diarrhea. This was complicated by acute truncal ataxia, lethargy, and hypertonicity.
-lactic acidosis
-epilepsia partialis
-movement disorder (ataxia)
-liver failure
-encephalopathy
-vomiting
-diarrhea
-cortical blindness
infantile
1.58n/a3.5Naviaux and Nguyen, 2004;

[view data]

646Nonsense
mutation:
E873X
A467T2
Nonsense
mutation:
E873X
He had been well and developmentally normal until 15 months when he suffered 3 days of a diarrheal illness and required admission for new ataxia and encephalopathy. On the day of admission, he developed status epilepticus and was intubated for 3 weeks for aspiration pneumonia. He developed progressive hepatic failure and cortical blindness. He remained in a vegetative state until he died. Autopsy showed massive cerebellar and cerebral atrophy.
-status epilepticus
-movement disorder (ataxia)
-liver failure
-encephalopathy
-diarrhea
-cortical blindness
infantile
1.25n/a1.3Naviaux and Nguyen, 2004;

[view data]

647Nonsense
mutation:
E873X
A467T2
Nonsense
mutation:
E873X
At 11 months, she developed otitis media and shortly thereafter she was admitted to the intensive care unit and intubated and treated for 2 days for apnea associated with an episode of absence status epilepticus. Brain computed tomography at that time was normal. Her gait was ataxic after recovery, and she had bouts of epilepsia partialis continua, initially involving the left hand. At 16 months, she suffered another episode of status epilepticus requiring intubation for airway protection and ventilatory support. Head control was lost permanently after this episode. she was found to have cortical blindness, and brain magnetic resonance imaging showed marked cerebral atrophy without focal abnormalities. A liver biopsy showed chronic and acute liver disease with micronodular cirrhosis, hepatocyte dropout, microvesicular fat, and bile ductular proliferation. The diagnosis of Alpers’ syndrome was made at that time. refractory partial seizures, scoliosis, quadriparesis, tracheomalacia, and osteoporosis and was aphasic.
-status epilepticus
-epilepsia partialis
-liver dysfunction
-cortical blindness
-Alpers syndrome
-encephalopathy
-developmental delay
infantile
0.9n/a10Naviaux and Nguyen, 2004;

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648Nonsense
mutation:
R374X
A467T2
Epilepsy, hepatopathy, movement disorder (present but not prominent)
-epilepsy
-movement disorder (ataxia)
infantile
0.33n/an/aAshley et al, 2008;

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649Indel:
W347_L365del
A467T2
Epilepsy, hepatopathy, movement disorder (present but not prominent)
-epilepsy
-movement disorder (ataxia)
infantile
0.58n/an/aAshley et al, 2008;

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658A467T2
G303R3
Alpers
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
infantile
n/an/a0.92Baruffini et al, 2011;

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659A467T2
G303R3
Alpers
-Alpers syndrome
-encephalopathy
-developmental delay
-epilepsy
infantile
n/an/a0.42Baruffini et al, 2011;

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662A467T2
A467T2
Alpers. Speech and motor delay were noted at the age of two years. At three years she developed epilepsy and six months later experienced migrainous attacks associated with vomiting, vertigo and transient left-sided weakness. At the age of five years she developed status epilepticus. A month later she was noted to have nystagmus, hypotonia of the lower limbs and absent knee jerks. Liver dysfunction.
-status epilepticus
-epilepsy
-liver dysfunction
-hypotonic
-vomiting
-Alpers syndrome
-nystagmus
-encephalopathy
-developmental delay
childhood
3n/a5.5Rajakulendran et al, 2016;

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663A467T2
A467T2
MEMSA. sensory neuropathy affecting legs. normal development until the age of 6 years when she presented with an encephalopathic illness consisting of impaired consciousness, vomiting and generalised tonic-clonic seizures. One week later she developed a left homonymous hemianopia. She remained stable until the age of 13 years when she developed stimulus sensitive myoclonus, tremor and a progressive cerebellar ataxia. Mildly elevated blood lactate and alanine levels and a sensory axonal peripheral neuropathy. occipital lobe infarcts. COX negative fibres. gaze-evoked nystagmus at 17. hand tremor, stimulus- sensitive myoclonus, head titubation, and gait ataxia.
-myoclonic seizures
-cerebellar ataxia
-movement disorder (ataxia)
-peripheral neuropathy
-vomiting
-nystagmus
-tremor
childhood
616n/aRajakulendran et al, 2016;

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664A467T2
A467T2
SANDO. Severe axonal neuropathy. COX-negative fibres, ragged red fibres. presented at the age of 20 years with diplopia and bilateral ptosis. Over the next five years he developed dysphagia, slurred speech and an unsteady gait. tingling sensation in hands, feet, leg, trunk and arms. at 44 years demonstrated bilateral ptosis and limitation of eye movements in all directions of gaze. dysarthria. Romberg’s test was positive. ataxic gait. axonal sensory peripheral neuropathy. ragged red fibres and more than 10 COX-negative fibres.
-movement disorder (ataxia)
-peripheral neuropathy
-demyelinating neuropathy
-ragged red fibers
-cox-negative
-ptosis
-diplopia
-dysphagia
-dysarthria
adult
2044n/aRajakulendran et al, 2016;

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665A467T2
A467T2
MELAS. Occipital headaches. left homonymous hemianopia suggestive of a stroke-like episode. right occipital infarct. Jerking movements of her left arm suggestive of epilepsia partialis continua with dystonia, which was refractory to treatment. She developed an asymptomatic axonal neuropathy, deafness and myopathic weakness. bilateral ptosis, ophthalmoparesis, a dense left homonymous hemianopia, dysarthric speech, increased tone with clawing of the left hand, and distal muscle weakness. In addition, Romberg’s test was positive and she walked with a wide-based gait. ataxic gait. axonal sensory motor neuropathy. ragged red fibres and COX-negative fibres.
-epilepsia partialis
-movement disorder (ataxia)
-demyelinating neuropathy
-ragged red fibers
-muscle weakness
-cox-negative
-ptosis
-PEO
-stroke
-headache/ migraine
-dystonia
adult
2431n/aRajakulendran et al, 2016;

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666Splice site
mutation:
c.1250+5G>C
A467T2
Parkinsons, PEO, short-term memory problems, general cerebral and cerebellar atrophy.
-cerebellar atrophy
-PEO
-parkinson's disease
adult
5081n/aMartikainen et al, 2016;

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671A467T2
A467T2
At 21 years, presented with a first generalized tonic–clonic seizure. She complained of migraine afterward and developed a convulsive status epilepticus. Visual hallucinations, jerking of the right arm with secondary generalization. She died 7 months after initial presentation.
-status epilepticus
-headache/ migraine
adult
212121.6Janssen et al, 2016;

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673A467T2
A467T2
Sudden falls, frequent negative myoclonus, ataxic gait and loss of proprioception in the distal extremities with nerve conduction studies demonstrating a mild axonal sensory polyneuropathy. myoclonic status epilepticus, generalized tonic–clonic seizure.
-status epilepticus
-myoclonic seizures
-movement disorder (ataxia)
-polyneuropathy
childhood
121827Janssen et al, 2016;

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674W748S5
E1143G
A467T2
Migraine, ataxia, polyneuropathy. focal seizures with visual symptoms and motor signs, and secondary generalized tonic-clonic seizure. Clinical neurological examination revealed an ataxic gait and areflexia with sensory loss. Convulsive status epilepticus. Cerebral MRI revealed a left occipital and left thalamic lesion.
-status epilepticus
-focal seizures
-movement disorder (ataxia)
-polyneuropathy
-headache/ migraine
-areflexia
juvenile
172023Janssen et al, 2016;

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676W748S5
A467T2
She had occipital lobe and secondarily generalized seizures. In addition, she had PEO, truncal and appendicular ataxia and peripheral neuropathy with diminished vibration sense and areflexia. She reported sporadic occurrence of seizures with a frequency of once in every few months.
-movement disorder (ataxia)
-peripheral neuropathy
-PEO
-areflexia
adult
2147n/aJanssen et al, 2016;

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677W748S5
E1143G
A467T2
Presented with status epilepticus, occipital lobe seizures. Further neurologic examination showed ataxic gait and appendicular ataxia. chronic sensory axonal polyneuropathy. Cognitive decline. At follow-up consultation 6 months after the initial presentation, she had not experienced any more seizures.
-status epilepticus
-movement disorder (ataxia)
-polyneuropathy
-axonal sensorimotor polyneuropathy
juvenile
1818.7n/aJanssen et al, 2016;

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684Nonsense
mutation:
E873X
A467T2
mtDNA depletion (30% in muscle), epilepsy, hepatopathy, movement disorder
-epilepsy
-movement disorder (ataxia)
infantile
1.5n/an/aAshley et al, 2008;

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688T914P1
A467T2
Hepatopathy
-no known symptoms
juvenile
15n/an/aAshley et al, 2008;

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689G848S1
A467T2
Hepatopathy, Epilepsy, Hepatopathy,
-epilepsy
infantile
1.5n/an/aAshley et al, 2008;

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690A467T2
A467T2
Epilepsy, ataxia
-epilepsy
-movement disorder (ataxia)
juvenile
16n/an/aAshley et al, 2008;

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697A467T2
A467T2
During his early childhood, he had frequent “acetonaemic vomiting” and stunted growth. At age 7 years, he developed EPC and sensory ataxia. epilepsia partialis continua, followed by progressive ataxia Reduced density of the white matter. behavioural problems. Elevated blood lactate. myoclonic seizures. sensory ataxia, absent deep tendon reflexes, cerebellar dysfunction, nystagmus, peripheral vision defect, and a pale optic disk. mild atrophy of the frontal,parietal and visual cortices, focal hyperlucencies of the frontal and occipital cortex, as well as of the thalamus bilaterally, and cerebellar atrophy. COX-negative fibres. partial and generalized seizures as well as myoclonic fits.
-myoclonic seizures
-epilepsia partialis
-movement disorder (ataxia)
-cerebellar atrophy
-sensory ataxia
-cox-negative
-vomiting
-nystagmus
childhood
71819Simonati et al, 2003a;

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702G848S1
A467T2
He developed normally in the first 6 months. Refusal of food and failure to thrive were noted from the 7th month of life. At 1 year of age, increased transaminase levels in the blood were accompanied by liver enlargement and hyperecogenicity. Motor development was delayed. hypoglycaemic episodes and lactic acidosis. A liver biopsy at the age of 16 months revealed steatosis and fibrosis. At 20 months of age, he had numerous episodes of status epilepticus and epilepsia partialis continua. The patient died at 2.5 years of age during an episode of status epilepticus. Alpers’ syndrome.
-lactic acidosis
-status epilepticus
-epilepsia partialis
-failure to thrive
-Alpers syndrome
-encephalopathy
-developmental delay
infantile
0.5n/a2.5Ferrari et al, 2005;

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703Splice site
mutation:
c.3482+2T>C
A467T2
mental and motor developmental delay. At the age of 7 years, strabismus convergens\\ occurred. headache and nausea and\\ then presented with a generalized tonic-clonic seizure. myoclonia, focal motor seizures evolved into epilepsia partialis continua. Alpers. During the first 4 months of his illness, the boy became blind and incontinent and lost his ability to walk freely. During the\\ ensuing years, a further slight loss of mental and motor capabilities and several episodes of status epilepticus occurred.
-status epilepticus
-epilepsia partialis
-headache/ migraine
-developmental delay
-Alpers syndrome
-encephalopathy
childhood
411n/aFlemming, et al 2002;

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704A957P1
A467T2
mild motor retardation was first noted at 6 months. At the age of 16 months, he was admitted to a local hospital for status epilepticus. At 18 months, generalized brain atrophy. epilepsia partialis continua, which was partially controlled by carbamazepine, later switched to oxcarbazepine. Elevated blood lactate. Alpers. He died at 2 years of age after severe complications from liver failure.
-status epilepticus
-epilepsia partialis
-liver failure
-retardation
-Alpers syndrome
-encephalopathy
-developmental delay
infantile
0.5n/a2Ferrari et al, 2005;

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706Nonsense
mutation:
c.3626_3629dupGATA
A467T2
Alpers. At 1 year of age, she presented a rightsided clonic status epilepticus resistant to multiple antiepileptic drugs. Carbamazepine worsened myoclonic jerks. A ketogenic diet was well tolerated but was ineffective. At 12 months, dramatic psychomotor regression was observed with poor interaction, major global hypotonia and no eye contact due to cortical blindness. epilepsia partialis continua reinforced by recurrent episodes of tonic clonic seizures. At 16 months of age, liver enlargement was noticed associated with mild cytolysis. The patient died at 27 months of age of respiratory failure.
-status epilepticus
-epilepsia partialis
-hypotonic
-cortical blindness
-respiratory deficiency
-Alpers syndrome
-encephalopathy
-developmental delay
infantile
0.5n/a2.25Mousson de Camaret et al, 2011

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1-5 pathogenic cluster assignment of mutations. Mutations displayed without a superscript number are outside of the assigned pathogenic clusters. See cluster definitions for details.

Number of displayed patient cases: 236
Number of patient cases marked as outliers: 2 (cases excluded from avg: 409, 666)
Avg age of onset in displayed cases: 14.8
Std dev in onset in displayed cases: 16.5

Search criteria for patient entries:
Mutations Entry IDs Clusters Reference Residue range
Mutations:
Allele 1:Allele 2:
Separate multiple mutations with commas.
Use "PNF" for non-missense mutations.
Match: Inclusive Exact
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