Megalencephalic leukoencephalopathy with subcortical cysts is a rare leukodystrophy characterized by macrocephaly and a slowly progressive clinical course marked by spasticity and cognitive decline. We report two full siblings with neuroimaging studies and clinical courses typical for megalencephalic leukoencephalopathy with subcortical cysts, in whom a pair of novel mutations in the MLC1 gene was identified. We review the current knowledge of this disorder in relation to the patients reported.
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References
1.
van der KnaapMSBarthPGStroinkH: Leukoencephalopathy with swelling and a discrepantly mild clinical course in eight children. Ann Neurol1995;37:324–334.
2.
Ben ZeevBGrossVKushnirT: Vacuolating megalencephalic leukoencephalopathy in 12 Israeli patients. J Child Neurol2001;16:93–99.
3.
BiancheriRPisaturoCPerroneMV: Presence of delayed myelination and macrocephaly in the sister of a patient with vacuolating leukoencephalopathy with subcortical cysts. Neuropediatrics2000;31:321–324.
4.
BugianiMMoroniIBizziA: Consciousness disturbances in megalencephalic leukoencephalopathy with subcortical cysts. Neuropediatrics2000;34:211–214.
5.
CartwrightJDGottlichE: Megaloencephaly and leukoencephalopathy of infantile onset with mild clinical course. Brain Dev1998;20:376.
6.
GoutieresFBoullocheJBourgeoisMAicardiJ: Leukoencephalopathy, megalencephaly, and mild clinical course. A recently individualized familial leukodystrophy. Report on five new cases. J Child Neurol1996;111:439–444.
7.
GulatiSKabraMGeraS: Infantile-onset leukoencephalopathy with discrepant mild clinical course. Indian J Pediatr2000;67:769–773.
8.
HiguchiYHattoriHTsujiM: Partial seizures in leukoencephalopathy with swelling and a discrepantly mild clinical course. Brain Dev2000;22:387–389.
9.
KoedaTTakeshitaK: Slowly progressive cystic leukoencephalopathy with megalencephaly in a Japanese boy. Brain Dev1998;20:245–249.
10.
Mejaski-BosnjakVBesenkiN: Megalencephalic leukoencephalopathy: A further case of a neurodegenerative white matter disease. Dev Med Child Neurol1997;39:561–563.
11.
Mejaski-BosnjakVBesenskiNBrockmannK: Cystic leukoencephalopathy in a megalencephalic child: Clinical and magnetic resonance imaging/magnetic resonance spectroscopy findings. Pediatr Neurol1997;16:347–350.
12.
PisaturoCBiancheriRPerroneMV: Leucodistrofia con macrocefalia e decorso clinico sorprenentemente lieve. Minerva Pediatr1999;51:399–402.
13.
SinghalBSGursahaniMDUdaniVPBiniwaleAA: Megalencephalic leukodystrophy in an Asian Indian ethnic group. Pediatr Neurol1996;14:291–296.
14.
SaijoHNakayamaHEzoeT: A case of megalencephalic leukoencephalopathy with subcortical cysts (van der Knaap disease): Molecular genetic study. Brain Dev2003;25:362–366.
15.
TakanashiJSugitaKKohnoY: Vacuolating leukoencephalopathy with subcortical cysts with late onset athethoid movements. J Neurol Sci1999;165:90–93.
16.
ThelleTBalslevTChristensenT: van der Knaap's vacuolating leukoencephalopathy: Two additional cases. Eur J Paediatr Neurol1999;3: 83–86.
17.
TopcuMSaatciITopcuogluMA: Megalencephaly and leukodystrophy with mild clinical course: A report on 12 new cases. Brain Dev1998;20:142–153.
18.
YakinciCSoyluHKotluNOSenerRN: Leukoencephalopathy with a mild clinical course: A case report. Comput Med Imaging Graph1999;23:169–172.
19.
YalcinkayaCComuSKocerN: Siblings with cystic leukoencephalopathy and megalencephaly. J Child Neurol2000;15:690–693.
20.
YalcinkayaCYukselAComuS: Epilepsy in vacuolating megalencephalic leukoencephalopathy with subcortical cysts. Seizure2003;12:388–396.
21.
Yapýcý-UcgulZUcgulADenizE: Cystic leukoencephalopathy with megalencephaly in two siblings: Clinical characteristics in MRI and MRS findings. Brain Dev1998;20:376.
22.
De StefanoNBalestriPDottiMT: Severe metabolic abnormalities in the white matter of patients with vacuolating megalencephalic leukoencephalopathy with subcortical cysts. J Neurol2001;248:403–409.
23.
BrockmannKFinsterbuschJTerweyB: Megalencephalic leukoencephalopathy with subcortical cysts in an adult: Quantitative proton MR spectroscopy and diffusion tensor MRI. Neuroadiology2003;45:137–142.
24.
KayeEM: Disorders primarily affecting the white matter, in SwaimanKFAshwalS, (eds): Pediatric Neurology: Principles and Practice.St. Louis, Mosby, 1999, 849–859.
25.
BarkovichAJ: Toxic and metabolic disorders, in BarkovichAJ, (ed): Pediatric Neuroimaging, 3rd ed. Philadelphia, Lippincott Williams and Wilkins, 2000, 90–92.
26.
ToftPBGeiss-HoltorffRRollandMO: Magnetic resonance imaging in juvenile Canavan disease. Eur J Pediatr1993; 152:750–753.
27.
HarbordMGHardenAHardingB: Megalencephaly with dysmyelination, spasticity, ataxia, seizures and distinctive neurophysiological findings in two siblings. Neuropediatrics1990;21:164–168.
28.
LeegwaterPAJPronkJCvan der KnaapM: Leukoencephalopathy with vanishing white matter: From magnetic resonance imaging pattern to five genes. J Child Neurol2003;18:639–645.
29.
van der KnappMSBarterPGVrensenGFJMValkJ: Histopathology of an infantile onset spongiform leukoencephalopathy with a discrepantly mild clinical course. Acta Neuropathol (Berl)1996;92: 206–212.
30.
TopcuMGartiouxCRibierrneF: Vacuolating megalencephalic leukoencephalopathy with subcortical cysts. Mapped to chromosome 22qAm J Hum Genet2000;66:733–739.
31.
LeegwaterPABoorPKYuanBQ: Identification of novel mutations in MLC1 responsible for megalencephalic leukoencephalopathy with subcortical cysts. Hum Genet2002;110:279–283.
32.
LeegwaterPAYuanBQvan der SteenJ: Mutations of MLC1 (K1AA0027), encoding a putative membrane protein, cause megalencephalic leukoencephalopathy with subcortical cysts. Am J Hum Genet2001;68:831–838.
33.
BlattnerRvon MoersALeegwaterPAJ: Clinical and genetic heterogeneity in megalencephalic leukoencephalopathy with subcortical cysts (MLC). Neuropediatrics2003;34:215–218.
34.
PatronoCDiGiacintoGEymard-PierreE: Genetic heterogeneity of megalencephalic leukoencephalopathy and subcortical cysts. Neurology2003;61:534–537.
35.
MeyerJHuberthAOrtegaG: A missense mutation in a novel gene encoding putative cation channel is associated with catatonic schizophrenia in a large degree. Mol Psychiatry2001;6: 302–306.
36.
RubieCLichtnerPGartnerJ: Sequence diversity of K1AA0027/MLC1: Are megalencephalic leukoencephalopathy and schizophrenia allelic disorders?Hum Mutat2003;21:45–52.