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Neurological aspects of hyperinsulinism–hyperammonaemia syndrome
Author(s) -
BahiBuisson Nadia,
Roze Emmanuel,
Dionisi Carlo,
Escande Fabienne,
Valayannopoulos Vassili,
Feillet François,
Heinrichs Claudine
Publication year - 2008
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.2008.03114.x
Subject(s) - congenital hyperinsulinism , hyperinsulinism , epilepsy , medicine , missense mutation , pediatrics , dystonia , endocrinology , mutation , gastroenterology , genetics , insulin , gene , biology , psychiatry , insulin resistance
Hyperinsulinism–hyperammonaemia syndrome (HHS) is a rare cause of congenital hyperinsulinism, due to missense mutations in the GLUD1 gene, resulting in glutamate dehydrogenase (GDH) overactivity. The aim of this study was to document the spectrum of neurological disturbances associated with HHS and to identify possible phenotype–genotype correlations. We retrospectively analyzed the neurological outcomes of 22 consecutive patients (12 males, 10 females) aged from 18 months to 40 years and diagnosed with HHS. We analyzed demographic and clinical features and neuroradiological, biochemical, and genetic findings. Fourteen patients had childhood‐onset epilepsy. Learning disability* was found in 17 patients. Two patients had pyramidal involvement and one had generalized dystonia. Seizures were observed in 11 of 19 patients with documented GLUD1 mutations, and nine of these 11 patients had a mutation in the guanosine triphosphate (GTP) binding site. Our data demonstrate that neurological disorders in HHS are more frequent than previously thought and might suggest that mutations in the GTP binding site of GDH could be associated with more frequent epilepsy.