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Neuropathology in succinic semialdehyde dehydrogenase deficiency.

Abstract
Reported here is the novel finding of neuropathology in a patient with succinic semialdehyde dehydrogenase deficiency, an inherited disorder of gamma-aminobutyric acid metabolism characterized by intellectual deficiency, hypotonia, and epilepsy, with 4-hydroxybutyric aciduria and abnormalities of the globus pallidus on neuroimaging. A 19-year-old woman of European origin with a neurodevelopmental disorder and epilepsy died unexpectedly in 1998. A postmortem examination was performed, with a final diagnosis of sudden unexpected death in epilepsy patients. Eight years later, her sister with a neurodevelopmental disorder presented at 13 years of age with seizures and was diagnosed with succinic semialdehyde dehydrogenase deficiency. In the decedent, succinic semialdehyde dehydrogenase deficiency was established at the molecular level, 10 years after her death, using genomic DNA from brain tissue specimens. The neuropathologic findings revealed striking discoloration of the globi pallidi, leptomeningeal congestion, and a scar in the frontal cortex. After detection of the pathogenic homozygous mutation c.1226G>A, p.Gly409Asp in the living sister, it was confirmed in the decedent. An underlying metabolic disease may be an additional risk factor for sudden unexpected death in epilepsy patients.
AuthorsIna Knerr, K Michael Gibson, Geoffrey Murdoch, Gajja S Salomons, Cornelis Jakobs, Susan Combs, Phillip L Pearl
JournalPediatric neurology (Pediatr Neurol) Vol. 42 Issue 4 Pg. 255-8 (Apr 2010) ISSN: 1873-5150 [Electronic] United States
PMID20304328 (Publication Type: Case Reports, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
CopyrightCopyright 2010 Elsevier Inc. All rights reserved.
Chemical References
  • ALDH5A1 protein, human
  • Succinate-Semialdehyde Dehydrogenase
Topics
  • Adolescent
  • Base Sequence
  • Brain (pathology)
  • Brain Diseases, Metabolic, Inborn (genetics, pathology)
  • Death, Sudden
  • Fatal Outcome
  • Female
  • Humans
  • Mutation, Missense
  • Seizures (genetics, pathology)
  • Sequence Analysis, DNA
  • Succinate-Semialdehyde Dehydrogenase (deficiency, genetics)
  • White People
  • Young Adult

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