Abstract
Electron microscopic and enzyme histochemical studies were performed on the cerebellum and the ocular and deltoid muscles from a 38 year old woman who developed bilateral ptosis at the age of nine years. Histologically the cerebellum appeared normal. The biopsies of three ocular muscles showed varying sizes of muscle fibers which were rounded and contained increased numbers of subsarcolemmal nuclei. The deltoid muscle stained by hematoxylin and eosin appeared normal, but the trichrome stain showed increased numbers of red granules within the sarcolemma corresponding ultrastructurally to increased numbers of abnormal mitochondria. These abnormal mitochondria displayed increased reaction products with LDH, NADH and SDH preparations, while the muscle gave normal reaction in phosphorylase, PAS and myosin ATP preparations. Chemical studies on the cerebellum showed normal proteolipids, glycolipids and phospholipids. Ultrastructurally, the cerebellum, the myofibers of three ocular muscles and the deltoid muscle exhibited abnormal mitochondria which showed peculiarly arranged circular cristae. They frequently contained paracrystalline structures which consisted of individual tubules arranged in a helical pattern. Frequently, the abnormal mitochondria were replaced by dense rectangular inclusions and occasionally showed complete transition to crystalline structures.
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