Neuropathy, ataxia, and retinitis pigmentosa

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Neuropathy, ataxia, and retinitis pigmentosa
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Peripheral neuropathy, ataxia, retinitis pigmentosa
Complications	N/A
Onset	Childhood or early adulthood
Duration	Lifelong
Types	N/A
Causes	Mutations in mitochondrial DNA
Risks	Family history of mitochondrial disorders
Diagnosis	Genetic testing, clinical examination
Differential diagnosis	N/A
Prevention	N/A
Treatment	Supportive care, physical therapy, occupational therapy
Medication	N/A
Prognosis	Variable, progressive
Frequency	Rare
Deaths	N/A

Neuropathy, Ataxia, and Retinitis Pigmentosa (NARP) is a rare genetic disorder that affects the nervous system, leading to a combination of neurological symptoms. The condition is characterized by the triad of its namesake symptoms: neuropathy (nerve damage), ataxia (lack of muscle coordination), and retinitis pigmentosa (a group of genetic disorders that affect the retina and cause loss of vision). NARP is caused by mutations in the mitochondrial DNA, specifically in the MT-ATP6 gene, which plays a crucial role in cellular energy production.

Symptoms and Diagnosis

The symptoms of NARP can vary widely among individuals, even among members of the same family. The onset of symptoms typically occurs in childhood or early adulthood. The primary symptoms include:

• Neuropathy: This involves tingling, numbness, and pain in the hands and feet due to peripheral nerve damage.
• Ataxia: This manifests as problems with balance and coordination, leading to difficulty walking and performing tasks that require fine motor skills.
• Retinitis Pigmentosa: This condition causes progressive vision loss, starting with decreased night vision and loss of peripheral vision, eventually potentially leading to blindness.

Additional symptoms may include developmental delays, seizures, muscle weakness, hearing loss, and cognitive impairment. Diagnosis of NARP is based on clinical evaluation, family history, and genetic testing to identify mutations in the MT-ATP6 gene.

Genetics

NARP is a mitochondrial disorder, meaning it is caused by mutations in mitochondrial DNA (mtDNA). Mitochondria, the energy-producing organelles within cells, have their own DNA, which is inherited exclusively from the mother. The MT-ATP6 gene mutation responsible for NARP affects the ATP synthase protein, disrupting the mitochondria's ability to produce energy efficiently.

Treatment and Management

There is currently no cure for NARP, and treatment focuses on managing symptoms and improving quality of life. Management strategies may include:

• Physical therapy to improve mobility and muscle strength
• Vision aids and services to assist with visual impairments
• Medications to control seizures and manage pain
• Regular monitoring and supportive care for associated conditions

Genetic counseling is recommended for affected individuals and their families to understand the inheritance pattern and risks for future generations.

Prognosis

The prognosis for individuals with NARP varies depending on the severity of symptoms and the degree of organ involvement. While some individuals may lead relatively normal lives with mild symptoms, others may experience significant physical and cognitive disabilities. Early intervention and supportive care can help manage symptoms and improve outcomes.

NIH genetic and rare disease info

• NIH info on Neuropathy, ataxia, and retinitis pigmentosa

Neuropathy, ataxia, and retinitis pigmentosa is a rare disease.