Table 5b.

WARS2-Related Movement Disorder: Recommended Surveillance

System/ConcernEvaluationFrequency
Cerebellar involvement Clinical eval (using standardized scores, e.g., SARA) recommendedAt each visit
Parkinsonism Clinical eval using UPDRS
Action myoclonus Assess severity of myoclonus using UMRS.
Dysarthria Assess need for alternative communication method or speech therapy.
Activities of daily living Eval of rehab plan
School performance Interview
Cognitive/Psychiatric Evaluate mood, signs of psychosis, & cognitive complaints to identify need for pharmacologic & psychotherapeutic interventions.
Family support
& resources 		Assess family need for social work support (e.g., palliative/respite care, home nursing, other local resources), care coordination, or follow-up genetic counseling if new questions arise (e.g., family planning).

SARA = Scale for the Assessment and Rating of Ataxia; UMRS = Unified Myoclonus Rating Scale; UPDRS = Unified Parkinson's Disease Rating Scale

From: WARS2 Deficiency

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