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From St. Vincents University Hospital (Drs. ORiordan, McMonagle, and Prof. Hutchinson), Dublin; Department of Neuropathology (Prof. Farrell), Beaumont Hospital, Dublin, Ireland; Institute of Neurology (Drs. Janssen, Fox, and Prof. Rossor), Queen Square, London; and Department of Neurogenetics (Prof. Collinge), Imperial College School of Medicine, London, United Kingdom.
Address correspondence and reprint requests to Prof. M. Hutchinson, Department of Neurology, St. Vincents University Hospital, Elm Park, Dublin 4, Ireland; e-mail: michael.hutchinson{at}svcpc.ie
The authors report unusual presentations of members of an Irish family with familial AD due to an E280G mutation in exon 8 of presenilin-1. One had spastic paraparesis and white matter abnormalities on cranial MRI. A sibling had an internuclear ophthalmoplegia, spasticataxic quadriparesis, and "cotton-wool plaques" with amyloid angiopathy on brain biopsy. Another affected sibling also had MRI white matter abnormalities. The MRI findings may reflect an ischemic leukoencephalopathy due to amyloid angiopathy affecting meningocortical vessels.
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