Mendelssohn’s Premature Death

The medical basis for Felix Mendelssohn’s death at age 37 of a stroke—only a few months after his sister Fanny’s death of a stroke—has not to date been adequately described in the journal literature. But in recent years there has been intensive research on mutations of the NOTCH3 gene on chromosome 19. Might a NOTCH3 mutation have been the cause of Mendelssohn’s dying? We do not know. But the facts and family history are highly suggestive. NOTCH3 mutations give rise to a variety of hereditary abnormalities including stroke at an early age. Previously termed Familial Stroke Syndrome, CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy) is associated with NOTCH3 mutation. And within the past several years there is also now a commercial laboratory offering genomic testing for NOTCH3 variants. You may like to have a look at the sources below—especially if you have a family history anything like Mendelssohn’s?

Or not (as your own preferences and insurance coverage considerations suggest to you is best), inasmuch as there is presently no cure for the NOTCH3-related disorders. But knowing that you have a NOTCH3 point mutation may at least help as regards proper care in dosing with aspirin and other anticoagulants (“blood thinners”) either in surgery or on a chronic basis. And, since the condition is autosomal dominant (AD), knowing that you have it is very important for family planning and parent-child communication.

The person [electing to undertake voluntary genomic testing or screening] may benefit in the long run from making preventive lifestyle choices that will help counteract the biological risk [that is associated with the genotype that they have inherited].”
  —  Personalized Medicine, U.S. News & World Report, 23-APR-2008.

• CADASIL Foundation.
  
• AthenaDiagnostics Notch3 genomics test for stroke syndrome (CADASIL)
  
• Chromosome 19 page at NIH.gov
  
• Chromosome 19 page at Wikipedia.org
  
• U.S. Genetic Information Nondiscrimination Act of 2008 (GINA 2008)
  
• Coalition for Genetic Fairness
  
• Arboleda-Velasquez J, Zhou Z, Shin H, et al. Lining NOTCH signaling to ischemic stroke. PNAS 2008; 105:4856-61.
  
• Cherington M, Smith R, Nielsen P. The life, legacy and premature death of Felix Mendelssohn. Semin Neurol 1999; 19:47-52. (familial stroke syndrome)
  
• Dichgans M. Genetics of ischaemic stroke. Lancet Neurol. 2007. 6:149-61.
  
• Joutel A, Andreux F, Gaulis S, et al. The ectodomain of Notch3 receptor accumulates within cerebrovasculatory of CADASIL patients. J Clin Invest 2000; 105:597-605.
  
• Leib J, Gollust S, Hull S, Wilfond B. Carrier screening panels for Ashkenazi Jews: Is more better? Genet Med 2005; 7:185-90.
  
• Lina A, Basson C, Goldmuntz E, et al. Adults with genetic syndromes and cardiovascular abnormalities: clinical history and management. Genet Med 2008; 10:469-94.
  
• Oh J, Lee J, Kang S, Kang J, Choi J. Aspirin-associated intracerebral hemorrhage in a patient with CADASIL. Clin Neurol Neurosurg 2008; 110:384-6.
  
• Peters N, Freilinger T, Ppherk C, Pfefferkorn T, Dichgans M. Effects of short term atorvastatin treatment on cerebral hemodynamics in CADASIL. J Neurol Sci. 2007;260:100-5.
  
• Rice G, Boughner D, Stiller C, Ebers G. Familial stroke syndrome associated with mitral valve prolapse. Ann Neurol 1980; 7:130-4.
  
• Schmideler S, Somburg O, Steinberg H, Splett T. Felix Mendelssohn: The mystery of his early death. Fortschr Neurol Psychiatr 2006; 74:522-7.
  
• Wade N. A dissenting voice as the genome is sifted to fight disease. New York Times, 15-SEP-2008.
  
• Werbrouck B, de Bleecker J. Intracerebral haemorrhage in CADASIL. Acta Neurol Belg 2006; 106:219-21.
  
• Zicari E, Tassi R, Stromillo M, et al. Right-to-left shunt in CADASIL patients: prevalence and correlation with clinical and MRI findings. Stroke. 2008; 39:2155-7.
  
• Entine J. Abraham's Children: DNA of the Chosen People. GrandCentral, 2007.
  
• Goldstein D. Jacob's Legacy: A Genetic View of Jewish History. Yale Univ, 2008.
  
• Kleiman Y. DNA and Tradition: Genetic Link to the Ancient Hebrews. Devora, 2004.
  
• Rose C. Neurology of Music. Imperial College, 2009.