Familial fatal insomnia with atypical clinical features in a patient with D178N mutation and homozygosity for Met at codon 129 of the prion protein gene

Prion. 2015;9(3):228-35. doi: 10.1080/19336896.2015.1054601.

Abstract

Familial fatal insomnia (FFI) is fatal disorder characterized by damage to select thalamic nuclei, together with progressive insomnia and dysautonomia. In subjects carrying the D178N prion protein (PRNP) mutation, distinct phenotypes can be observed, depending on the methionine (Met) /valine (Val) codon 129 polymorphism. We report here a Chinese case of FFI with a D178N/Met129 genotype of the PRNP gene, who exhibited rapidly progressive dementia combined with behavioral disturbances and paroxysmal limb myoclonus. Our patient did not show refractory insomnia early in the disease course, nor demonstrate typical MRI and EEG alterations. There was remarkable family history of similar symptoms.

Keywords: D178N; D178N, Asp178Asn; FFI, familial fatal insomnia; Familial fatal insomnia; Met 129, Methionine 129; Met129; PRNP, prion protein; prion protein.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Base Sequence
  • Brain / pathology
  • Codon / genetics*
  • Electroencephalography
  • Female
  • Homozygote*
  • Humans
  • Insomnia, Fatal Familial / genetics*
  • Magnetic Resonance Imaging
  • Male
  • Methionine / genetics*
  • Middle Aged
  • Molecular Sequence Data
  • Mutation / genetics*
  • Pedigree
  • Prions / genetics*

Substances

  • Codon
  • Prions
  • Methionine