Megalencephalic leukoencephalopathy with subcortical cysts: Difference between revisions

From WikiMD's Wellness Encyclopedia

CSV import
CSV import
 
(3 intermediate revisions by the same user not shown)
Line 1: Line 1:
{{Infobox medical condition (new)
 
| synonyms        = Vacuolating megalencephalic leukoencephalopathy with subcortical cysts
{{Infobox medical condition
| name            = Megalencephalic leukoencephalopathy with subcortical cysts
| name            = Megalencephalic leukoencephalopathy with subcortical cysts
| image          =
| synonyms        = Van der Knaap disease
| caption        =
| field          = [[Neurology]]
| pronounce      =  
| symptoms        = [[Macrocephaly]], [[motor developmental delay]], [[seizures]], [[ataxia]], [[spasticity]]
| field          =  
| onset          = Infancy
| symptoms        =  
| duration        = Progressive
| complications  =
| causes          = Mutations in the [[MLC1]] or [[GLIALCAM]] genes
| onset          =  
| risks          = Genetic inheritance (autosomal recessive)
| duration        =  
| diagnosis      = [[Magnetic resonance imaging|MRI]], [[genetic testing]]
| types          =
| differential    = [[Alexander disease]], [[Canavan disease]], [[metachromatic leukodystrophy]]
| causes          =  
| treatment      = Symptomatic management, [[physical therapy]], [[occupational therapy]]
| risks          =  
| prognosis      = Variable, often progressive neurological decline
| diagnosis      =  
| frequency      = Rare
| differential    =  
| prevention      =
| treatment      =  
| medication      =
| prognosis      =  
| frequency      =  
| deaths          =
}}
}}
'''Megalencephalic leukoencephalopathy with subcortical cysts''' ('''MLC''', or '''Van der Knaap disease''') is a form of [[hereditary CNS demyelinating disease]]. It belongs to a group of disorders called [[leukodystrophies]].
{{Short description|A rare genetic disorder affecting the brain}}
 
{{Medical condition (new)}}
'''Megalencephalic leukoencephalopathy with subcortical cysts''' (MLC) is a rare [[genetic disorder]] characterized by an enlarged brain ([[megalencephaly]]), [[leukoencephalopathy]], and the presence of [[subcortical cysts]]. This condition primarily affects the [[central nervous system]] and is associated with a range of neurological symptoms.
==Presentation==
Individuals with MLC typically present with an abnormally large head size ([[macrocephaly]]) that is noticeable in infancy or early childhood. The condition is progressive, and affected individuals may develop [[motor skill]] difficulties, [[ataxia]], and [[spasticity]]. [[Seizures]] are also common in individuals with MLC.
==Pathophysiology==
MLC is caused by mutations in the [[MLC1]] or [[GLIALCAM]] genes. These genes are involved in the function of [[glial cells]], which are crucial for maintaining the [[myelin sheath]] that insulates [[nerve fibers]]. The mutations lead to a disruption in the [[blood-brain barrier]] and the accumulation of fluid in the brain, resulting in the characteristic [[white matter]] changes and cyst formation.
==Diagnosis==
Diagnosis of MLC is based on clinical evaluation, [[magnetic resonance imaging]] (MRI) findings, and genetic testing. MRI typically reveals diffuse white matter abnormalities and the presence of subcortical cysts, particularly in the [[temporal lobe]]s.
==Management==
There is currently no cure for MLC, and treatment is primarily supportive. Management focuses on controlling symptoms such as seizures and providing supportive therapies to improve [[quality of life]]. [[Physical therapy]], [[occupational therapy]], and [[speech therapy]] may be beneficial for affected individuals.
==Prognosis==
The prognosis for individuals with MLC varies. Some individuals may experience a relatively stable course, while others may have a more progressive decline in neurological function. Lifespan can be normal, but severe cases may lead to significant disability.
==Genetics==
==Genetics==
It is associated with [[MLC1]].<ref name="pmid16652334">{{cite journal  |vauthors=Ilja Boor PK, de Groot K, Mejaski-Bosnjak V, etal |title=Megalencephalic leukoencephalopathy with subcortical cysts: an update and extended mutation analysis of MLC1 |journal=Hum. Mutat. |volume=27 |issue=6 |pages=505–12 |date=June 2006 |pmid=16652334 |doi=10.1002/humu.20332}}</ref><ref>{{cite web |url=http://ghr.nlm.nih.gov/condition=megalencephalicleukoencephalopathywithsubcorticalcysts |title=Megalencephalic leukoencephalopathy with subcortical cysts - Genetics Home Reference |format= |website= |accessdate=2009-03-11}}</ref>
MLC is inherited in an [[autosomal recessive]] manner, meaning that an individual must inherit two copies of the mutated gene, one from each parent, to be affected. Carriers, who have only one copy of the mutation, typically do not show symptoms.
 
==Epidemiology==
==History==
MLC is a rare disorder, with a higher prevalence in certain populations, such as those of [[Indian]] or [[Roma]] descent. The exact incidence is unknown, but it is considered a rare condition worldwide.
A series of cases with megalencephalic leukodystrophy were described by the Indian neurologist [[Bhim Sen Singhal]] (1933-)in 1991.<ref>{{cite journal|author1=Singhal, BS |author2=Gursahani, RD |author3=Udani, VP |author4=Biniwale, AA|journal=Pediatric Neurology| date=May 1996 |volume=14|issue=4|pages=291–6|doi=10.1016/0887-8994(96)00048-3|pmid=8805171|title=Megalencephalic leukodystrophy in an Asian Indian ethnic group}}</ref><ref>{{cite journal |last1=Batla |first1=A |last2=Pandey |first2=S |last3=Nehru |first3=R |title=Megalencephalic leukoencephalopathy with subcortical cysts: A report of four cases |journal=Journal of Pediatric Neurosciences |date=January 2011 |volume=6 |issue=1 |pages=74–7 |doi=10.4103/1817-1745.84416 |pmid=21977097 |pmc=3173924|doi-broken-date=2019-08-20 }}</ref><ref> Singhal BS, Gursahani RD, Biniwale AA, Udani VP. Tokyo, Japan: In Proceedings of the 8th Asian and Oceanian Congress of Neurology; 1991. Megalencephalic leukodystrophy in India; p. 72.</ref> However, it is sometimes referred to as Van der Knaap disease after the Dutch neurologist [[Marjo van der Knaap]] who described another series of cases with clinical and radiological features in 1995.<ref>{{cite journal |last1=van der Knaap |first1=Marjo S. |last2=Wevers |first2=Ron A. |last3=Kure |first3=Shigeo |last4=Gabreëls |first4=Fons J. M. |last5=Verhoeven |first5=Nanda M. |last6=van Raaij-Selten |first6=Bertie |last7=Jaeken |first7=Jaak |title=Increased Cerebrospinal Fluid Glycine: A Biochemical Marker for a Leukoencephalopathy With Vanishing White Matter |journal=Journal of Child Neurology |date=2 July 2016 |volume=14 |issue=11 |pages=728–731 |doi=10.1177/088307389901401108 |pmid=10593550}}</ref><ref>{{cite journal |last1=van der Knaap |first1=MS |last2=Barth |first2=PG |last3=Stroink |first3=H |last4=van Nieuwenhuizen |first4=O |last5=Arts |first5=WF |last6=Hoogenraad |first6=F |last7=Valk |first7=J |title=Leukoencephalopathy with swelling and a discrepantly mild clinical course in eight children |journal=Annals of Neurology |date=March 1995 |volume=37 |issue=3 |pages=324–34 |doi=10.1002/ana.410370308 |pmid=7695231}}</ref><ref>{{cite journal |last1=van der Knaap |first1=Marjo S |last2=Boor |first2=Ilja |last3=Estévez |first3=Raúl |title=Megalencephalic leukoencephalopathy with subcortical cysts: chronic white matter oedema due to a defect in brain ion and water homoeostasis |journal=The Lancet Neurology |date=November 2012 |volume=11 |issue=11 |pages=973–985 |doi=10.1016/S1474-4422(12)70192-8 |pmid=23079554}}</ref>
==Related pages==
 
* [[Leukoencephalopathy]]
==References==
* [[Megalencephaly]]
{{reflist}}
* [[Genetic disorders]]
 
* [[Neurological disorders]]
== External links ==
[[Category:Genetic disorders]]
{{Medical resources
[[Category:Neurological disorders]]
|  DiseasesDB    = 33813
[[Category:Rare diseases]]
|  ICD10          = E75.2
|  ICD9          =
|  ICDO          =
|  OMIM          = 604004
|  MedlinePlus    =
|  eMedicineSubj  =
|  eMedicineTopic =
|  MeshID        = 
|  GeneReviewsNBK  = NBK1535
|  GeneReviewsName = Megalencephalic Leukoencephalopathy with Subcortical Cysts
|  Orphanet        = 2478
}}
*[https://www.ncbi.nlm.nih.gov/books/NBK1535/ GeneReview/NIH/UW entry on Megalencephalic Leukoencephalopathy with Subcortical Cysts]
 
{{CNS diseases of the nervous system}}
 
 
[[Category:Demyelinating diseases of CNS]]
[[Category:Genetic disorders with known gene but no known gene function]]
 
 
{{genetic-disorder-stub}}
{{dictionary-stub1}}
{{No image}}

Latest revision as of 03:40, 4 April 2025


Megalencephalic leukoencephalopathy with subcortical cysts
Synonyms Van der Knaap disease
Pronounce N/A
Specialty N/A
Symptoms Macrocephaly, motor developmental delay, seizures, ataxia, spasticity
Complications N/A
Onset Infancy
Duration Progressive
Types N/A
Causes Mutations in the MLC1 or GLIALCAM genes
Risks Genetic inheritance (autosomal recessive)
Diagnosis MRI, genetic testing
Differential diagnosis Alexander disease, Canavan disease, metachromatic leukodystrophy
Prevention N/A
Treatment Symptomatic management, physical therapy, occupational therapy
Medication N/A
Prognosis Variable, often progressive neurological decline
Frequency Rare
Deaths N/A


A rare genetic disorder affecting the brain


Template:Medical condition (new) Megalencephalic leukoencephalopathy with subcortical cysts (MLC) is a rare genetic disorder characterized by an enlarged brain (megalencephaly), leukoencephalopathy, and the presence of subcortical cysts. This condition primarily affects the central nervous system and is associated with a range of neurological symptoms.

Presentation[edit]

Individuals with MLC typically present with an abnormally large head size (macrocephaly) that is noticeable in infancy or early childhood. The condition is progressive, and affected individuals may develop motor skill difficulties, ataxia, and spasticity. Seizures are also common in individuals with MLC.

Pathophysiology[edit]

MLC is caused by mutations in the MLC1 or GLIALCAM genes. These genes are involved in the function of glial cells, which are crucial for maintaining the myelin sheath that insulates nerve fibers. The mutations lead to a disruption in the blood-brain barrier and the accumulation of fluid in the brain, resulting in the characteristic white matter changes and cyst formation.

Diagnosis[edit]

Diagnosis of MLC is based on clinical evaluation, magnetic resonance imaging (MRI) findings, and genetic testing. MRI typically reveals diffuse white matter abnormalities and the presence of subcortical cysts, particularly in the temporal lobes.

Management[edit]

There is currently no cure for MLC, and treatment is primarily supportive. Management focuses on controlling symptoms such as seizures and providing supportive therapies to improve quality of life. Physical therapy, occupational therapy, and speech therapy may be beneficial for affected individuals.

Prognosis[edit]

The prognosis for individuals with MLC varies. Some individuals may experience a relatively stable course, while others may have a more progressive decline in neurological function. Lifespan can be normal, but severe cases may lead to significant disability.

Genetics[edit]

MLC is inherited in an autosomal recessive manner, meaning that an individual must inherit two copies of the mutated gene, one from each parent, to be affected. Carriers, who have only one copy of the mutation, typically do not show symptoms.

Epidemiology[edit]

MLC is a rare disorder, with a higher prevalence in certain populations, such as those of Indian or Roma descent. The exact incidence is unknown, but it is considered a rare condition worldwide.

Related pages[edit]