Kearns-Sayre syndrome

Last revised by Daniel J Bell on 30 Jul 2019

Kearns-Sayre syndrome (KSS), also known as oculocraniosomatic disorder, is a rare multisystem mitochondrial disorder

The patient often presents with progressive external ophthalmoplegia 1. Neurologic symptoms develop in childhood or adolescence, usually before 20 years of age 3.

Other features include:

  • cardiac conduction defects 4
  • retinal pigmentation
  • ptosis

The disease is characterized by the ragged-red appearance of muscle fibers, and the presence of mitochondrial DNA (mtDNA) with large deletions in affected tissues. It tends to affect peripheral white matter early and preferential involvement of the globi pallidi and thalami.

It is sporadic in a majority of cases.

CT scan of the brain shows basal ganglia siderocalcific deposits and subcortical calcifications (with or without basal ganglia deposits), and diffuse supratentorial and infratentorial atrophy.

Cerebral, cerebellar and brainstem atrophy are mainstay features of the disease 2.

Signal characteristics include:

  • T2: subcortical prolongation with subcortical calcifications, with or without bilateral basal ganglia siderocalcific deposits.

It was initially described by Thomas P Kearns and George Pomeroy Sayre in 1958 5.

Imaging differential considerations include

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