Open AccessGlutaric aciduria type 1 with microcephaly: Masquerading as spastic cerebral palsy
Author(s) -
Indar Kumar Sharawat,
Indar Kumar Sharawat
Publication year - 2018
Publication title -
journal of pediatric neurosciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.247
H-Index - 18
eISSN - 1998-3948
pISSN - 1817-1745
DOI - 10.4103/jpn.jpn_79_17
Subject(s) - microcephaly , medicine , pediatrics , spasticity , glutaric acid , cerebral atrophy , hyperintensity , spastic quadriplegia , cerebral palsy , magnetic resonance imaging , compound heterozygosity , endocrinology , atrophy , pathology , radiology , anesthesia , psychiatry , biochemistry , mutation , biology , gene
Glutaric aciduria type 1 (GA-1) is an autosomal-recessive disorder caused by the deficiency of the mitochondrial enzyme glutaryl-CoA dehydrogenase. A 13-month-old boy presented with microcephaly, developmental delay, and progressive spasticity and was being treated as spastic cerebral palsy, later on had loss of developmental milestones after acute episode of illness at 12 months of age. The magnetic resonance imaging of brain revealed widened Sylvian fissure, hyperintensities in bilateral globus pallidus, and bilateral frontoparietal atrophy along with white matter loss. The urine examination by gas chromatography-mass spectroscopy revealed a marked excretion of glutaric acid and 3-hydroxyglutaric acid. The diagnosis of GA-1 was confirmed on the basis of characteristic neuroimaging, biochemical, and mutation studies. There are rare reports in the literature about association of GA-1 with microcephaly. The child was started on trihexyphenidyl, l -carnitine, and high-dose riboflavin, and dietary therapy in the form of low-protein diet was advised.