© 1994 Oxford University Press
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Evidence for recessive as well as dominant forms of startle disease (hyperekplexia) caused by mutations in the 
1 subunit of the inhibitory glycine receptor
1Departments of Psychological Medicine, University of Wales College of Medicine Health Park, Cardiff CF4, 4XN, UK 2Medical Genetics, University of Wales College of Medicine Health Park, Cardiff CF4 4XN, UK
Received August 1, 1994; Accepted September 16, 1994
Startle disease, or hyperekplexia, is characterized by an exaggerated startle reflex and neonatal hypertonla. An autosomal dominant form of the disorder Is associated with mutations In the same codon of the 
1 subunit of the inhibitory glycine receptor (GLRA 1) resulting in the substitution of an uncharged amlno acid for Arg271 in the mature protein. However, recessive transmission Is seen in the mouse mutant spasmodic which resembles startle disease phenotypcially and is also associated with mutations In Glra 1. We have confirmed the finding of Arg271 mutations In individuals with startle disease in a UK family showing autosomal dominant transmission. In addition we describe an apparently sporadic case, the offspring of a consanguineous mating, who Is homozygous for a novel mutation (T1112A) in GLRA 1, which results In the substitution of asparagine for isoleucine at position 244 of the mature protein. This suggests that human startle disease can display recessive as well as dominant inheritance resulting from different mutations in GLRA 1.
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