Table 1

Timeline table shows demography, clinical features and investigation outcome in 4 SPG 7 positive hereditary spastic paraparesis patients.

Patient characteristics	Patient 1	Patient 2	Patient 3	Patient 4
Gender	Male	Male	Male	Male
Onset (yrs)	32	46	45	47
Age (yrs) at presentation	42	50	70	61
First Review date	12.1.15	27.6.14	15.7.15	14.616
Symptoms at presentation	Slowly progressive ataxia-10years, slurred speech-3 years, pins and needles in left lower limb -2 years	Progressive both calf pain, incoordination and intermittent falls, lower limb weakness	Slowly progressive ataxia for 25 years bilateral ptosis-20 years slurred speech-7 years	Slowly progressive ataxia , frequent falls in last 3 years, intention tremor slurred speech -10 years
Past history	Occasional headache	nil	Prostate Carcinoms	Nil
Family history	nil	nil	Brother and Sister-undiagnosed spasticity	Nil
Clinical signs (1^st visit)	Dysarthria, cerebellar ataxia, spastic lower limbs, brisk both KJs, AJs, upgoing plantars, partial external ophthalmoplegia on horizontal gaze	Spastic and broad-based gait, impaired heel-toe walk, downgoing plantars but brisk KJs and AJs, partial external ophthalmoplegia on horizontal gaze, slow saccade	brisk lower limb reflexes, left LL drift, both upgoing plantars, broad based ataxic gait, impaired heel shin test, bilateral asymmetrical ptosis (L>R), partial external horizontal ophthalmoplegia	Both lower limb spasticity, both ankle clonus, brisk lower limb reflexes, absent plantar responses dysarthria, cerebellar ataxia
Patient Concerns	Multiple falls, job related concern, risk of transmission to next generation	Multiple falls, job fitness, Risk of transmission to children	Multiple falls, poor mobility, driving	Multiple falls, poor mobility