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Left hand dystonia as a recurring feature of a family carrying C9ORF72 mutation
  1. Simona Luzzi1,
  2. Francesca Girelli1,
  3. Chiara Fiori1,
  4. Valentina Ranaldi1,
  5. Sara Baldinelli1,
  6. Valentina Cameriere1,
  7. Mauro Silvestrini1,
  8. Leandro Provinciali1,
  9. Sara Rollinson2,
  10. Stuart Pickering-Brown2,
  11. David Mann2,
  12. Julie S Snowden2
  1. 1Department of Clinical and Experimental Medicine, Polytechnic University of Marche, Ancona, Italy
  2. 2Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
  1. Correspondence to Dr Simona Luzzi, Department of Experimental and Clinical Medicine, Neurologic Clinic, Marche Polytechnic University, Via Conca, 1, Torrette di Ancona, Ancona, 60020, Italy; s.luzzi{at}univpm.it, simonaluzzi{at}yahoo.it

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Introduction

The commonest genetic cause of frontotemporal dementia (FTD) is a hexanucleotide repeat expansion in the chromosome 9 open reading frame 72 gene (C9ORF72).1 ,2 The clinical presentation is heterogeneous.3 Patients with C9ORF72 expansions may exhibit behavioural variant FTD (bvFTD) with or without motor neuron disease, psychosis and non-fluent aphasia, and, more rarely, parkinsonian syndromes such as corticobasal syndrome (CBS).

We describe an Italian family carrying the C9ORF72 mutation in which prototypical features of FTD were, unusually, combined with an isolated left hand dystonia occurring in the absence of extrapyramidal signs or apraxia.

Case reports

The family was native to a small village in the Marche region of Italy. To preserve anonymity, family members are referred to by the abbreviation (AN) of the province (Ancona) where they were examined. Eight family members had dementia (see figure 1 for genealogical tree).

Figure 1

AN family pedigree.

Four family members were available for assessment: two sisters with FTD (AN1 and AN2), and a healthy brother (AN3) and cousin (AN4). AN6 and AN7 were reported to have died after a 6–10-year history of dementia beginning with behavioural problems/psychosis. AN8, AN9 and AN10 were also said to suffer from dementia, although no details were available.

Patient AN1

AN1, a 59-year-old right-handed woman, a native Italian housewife, presented with a 2-year history of behavioural problems. Early …

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