Giant axonal neuropathy

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Giant axonal neuropathy
Synonyms	GAN
Pronounce
Specialty	Neurology, Genetics
Symptoms	Peripheral neuropathy, ataxia, dysarthria, seizures, intellectual disability
Complications	N/A
Onset	Childhood
Duration	Progressive
Types	N/A
Causes	Mutations in the GAN gene
Risks
Diagnosis	Genetic testing, nerve biopsy
Differential diagnosis	Charcot-Marie-Tooth disease, Friedreich's ataxia
Prevention	N/A
Treatment	Supportive care, physical therapy, occupational therapy
Medication
Prognosis	Variable, often progressive
Frequency	Rare
Deaths

Introduction

Giant Axonal Neuropathy (GAN) is a rare genetic disorder that affects the nervous system. It is characterized by the abnormal growth of axons, which are the long, threadlike extensions of neurons that transmit nerve impulses. This condition is inherited in an autosomal recessive pattern, meaning that both copies of the gene in each cell have mutations.

Pathophysiology

GAN is caused by mutations in the GAN gene, which provides instructions for making a protein called gigaxonin. This protein is involved in the breakdown of intermediate filaments, which are part of the cell's cytoskeleton. In individuals with GAN, the abnormal gigaxonin leads to the accumulation of intermediate filaments in the axons, causing them to swell and become dysfunctional.

Clinical Features

The symptoms of Giant Axonal Neuropathy typically begin in early childhood. Affected individuals often experience:

• Peripheral neuropathy, leading to muscle weakness and loss of sensation in the arms and legs.
• Ataxia, or lack of coordination.
• Dysarthria, or difficulty speaking.
• Optic atrophy, which can lead to vision problems.
• Curly hair, which is a distinctive feature in many patients.

Diagnosis

Diagnosis of GAN is based on clinical evaluation, family history, and genetic testing. Nerve biopsy may reveal the characteristic giant axons filled with disorganized neurofilaments. Genetic testing can confirm mutations in the GAN gene.

Management

There is currently no cure for Giant Axonal Neuropathy. Management focuses on symptomatic treatment and supportive care, including:

• Physical therapy to maintain mobility and muscle strength.
• Occupational therapy to assist with daily activities.
• Speech therapy for communication difficulties.
• Orthopedic devices to support weakened limbs.

Prognosis

The progression of GAN varies among individuals, but it is generally a progressive disorder. Most affected individuals experience a decline in motor and sensory functions over time, leading to significant disability.

See also

• Peripheral neuropathy
• Autosomal recessive disorder
• Genetic testing