We read with great interest the article by Kapur and Goldman1 of a 54-year-old man with mutations for spinocerebellar ataxia types 2 (SCA2 ; 38/22 CAG repeats) and 10 (SCA10 ; 962/10 ATTCT repeats), with overlapping clinical features of the 2 forms of autosomal dominant ataxias. The subject was Mexican and Native American, with French ancestry.
We have been following up a 39-year-old Bolivian man with a 13-year history of slowly progressive gait imbalance and lower limb ataxia. The patient has a history of multiple generalized tonic-clonic and partial complex seizures from ages 10 to 13 years that responded to treatment with carbamazepine. No cause was found for these seizures. The patient also reported a history of motor and phonic tics since the age of 7 years that were still present at his presentation. The neurologic examination showed markedly slow ocular saccades, dysarthria, upper and lower limb dysmetria, dysdiadochokinesis, and wide-based ataxic gait. There was no evidence of nystagmus, retinal changes, parkinsonism, Romberg sign, altered reflexes, or peripheral neuropathy ().