Natural history of succinic semialdehyde dehydrogenase deficiency through adulthood.

Abstract:

OBJECTIVE:The natural history of succinic semialdehyde dehydrogenase (SSADH) deficiency in adulthood is unknown; we elucidate the clinical manifestations of the disease later in life. METHODS:A 63-year-old man with long-standing intellectual disability was diagnosed with SSADH deficiency following hospitalization for progressive decline, escalating seizures, and prolonged periods of altered consciousness. We present a detailed review of his clinical course and reviewed our SSADH deficiency database adult cohort to derive natural history information. RESULTS:Of 95 patients in the database for whom age at diagnosis is recorded, there are 40 individuals currently aged 18 years or older. Only 3 patients were diagnosed after age 18 years. Of 25 adults for whom data are available after age 18, 60% have a history of epilepsy. Predominant seizure types are generalized tonic-clonic, absence, and myoclonic. EEGs showed background slowing or generalized epileptiform discharges in two-thirds of adults for whom EEG data were collected. History of psychiatric symptoms was prominent, with frequent anxiety, sleep disturbances, and obsessive-compulsive disorder. CONCLUSIONS:We identified patients older than 18 years with SSADH deficiency in our database following identification and review of a patient diagnosed in the seventh decade of life. The illness had a progressive course with escalating seizures in the index case, with fatality at age 63. Diagnosis in adulthood is rare. Epilepsy is more common in the adult than the pediatric SSADH deficiency cohort; neuropsychiatric morbidity remains prominent.

journal_name

Neurology

journal_title

Neurology

authors

Lapalme-Remis S,Lewis EC,De Meulemeester C,Chakraborty P,Gibson KM,Torres C,Guberman A,Salomons GS,Jakobs C,Ali-Ridha A,Parviz M,Pearl PL

doi

10.1212/WNL.0000000000001906

subject

Has Abstract

pub_date

2015-09-08 00:00:00

pages

861-5

issue

10

eissn

0028-3878

issn

1526-632X

pii

WNL.0000000000001906

journal_volume

85

pub_type

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