J Korean Acad Rehabil Med.  2002 Oct;26(5):626-630.

X-linked Recessive Bulbospinal Muscular Atrophy (Kennedy's Syndrome): A case report

Affiliations
  • 1Department of Rehabilitation Medicine, Seoul Veterans Hospital, Korea.
  • 2Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Korea. rmpyrn@amc.seoul.kr
  • 3Department of Medical Genetics Clinic and Laboratory, Asan Medical Center, University of Ulsan College of Medicine, Korea.

Abstract

X-linked recessive bulbospinal muscular atrophy (Kennedy's syndrome) is a variant of the spinal muscular atrophies caused by mutation of androgen receptor gene on X-chromosome. A 69-year-old man had suffered from slowly progressive lower extremity weakness and gynecomastia. Muscle weakness was more severe in proximal muscles and showed symmetrical features. He had fascicular contraction on his face and tongue. All tendon reflexes were absent and pyramidal signs were not detected. Nerve conduction studies were normal except low amplitude of sensory nerve action potential in median nerve. Needle electromyography revealed widespread chronic denervation potentials in all sampling muscles of extremities, facial and tongue muscles. Histopathologic findings showed chronic denervation atrophy. DNA analysis showed abnormal expansion of CAG repeats in the androgen receptor gene and we confirmed this case as Kennedy's syndrome. If an adult patient has slowly progressive muscle weakness, bulbar symptoms and signs of male genital failure, DNA analysis should be taken to differentiate Kennedy syndrome from other motor neuron disease or myopathy.

Keyword

Muscular atrophy; Spinal; X-chromosome; Gynecomastia; Trinucleotide repeats

MeSH Terms

Action Potentials
Adult
Aged
Atrophy
Bulbo-Spinal Atrophy, X-Linked
Denervation
DNA
Electromyography
Extremities
Gynecomastia
Humans
Lower Extremity
Male
Median Nerve
Motor Neuron Disease
Muscle Weakness
Muscles
Muscular Atrophy*
Muscular Diseases
Needles
Neural Conduction
Receptors, Androgen
Reflex, Stretch
Tongue
Trinucleotide Repeats
DNA
Receptors, Androgen
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