Canavan disease is a rare fetal inherited leukodystrophy, caused by accumulation of N-acetyl-aspartate in the brain. Here, we report a child presented with frequent intractable seizures and visual impairment. A 14-month-old female infant with a complaint of the absence of neck holding and generalized tonic-clonic seizures was referred to our hospital. Macrocephaly, setting sun eyes, tremor, and hypotonia were observed. Funduscopy showed optic atrophy. Our patient's flash visual evoked potential showed blindness. Her brain magnetic resonance imaging showed diffuse white matter in subcortical, basal ganglia, and dorsal pons. Electroencephalography showed diffuse slow and sharp waves. The genetic study detected a hemizygous mutation in the aspartoacylase gene. Our patient was diagnosed with Canavan disease and began anticonvulsant treatment. However, seizures were not under control. Then, her medications were discontinued, and clobazam and primidone were administered. In conclusion, starting clobazam and primidone may help prevent frequently intractable seizures in Canavan disease patients.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10034305PMC
http://dx.doi.org/10.1177/2050313X231160885DOI Listing

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Article Synopsis
  • Canavan disease (CD) is a rare genetic disorder caused by mutations in the ASPA gene, leading to high levels of N-acetylaspartate (NAA) in the body and severe developmental issues in infants.
  • A subset of patients displays milder symptoms, possibly due to some remaining ASPA activity, raising the question of how urine NAA levels relate to this.
  • A study found that individuals with the mild phenotype had significantly lower urine NAA levels and specific ASPA mutations that were absent in those with the typical phenotype, indicating that urine NAA can be used to differentiate between the two types of CD.
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Neurology

December 2024

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