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Related Experiment Videos

Alexander's disease: clinical, pathologic, and genetic features.

Anne B Johnson1, Michael Brenner

  • 1Department of Pathology-K604, Albert Einstein College of Medicine, 1300 Morris Park Ave., Bronx, NY 10461, USA. abminkoff@att.net

Journal of Child Neurology
|October 24, 2003
PubMed
Summary

Alexander disease is a rare neurological disorder affecting all ages, characterized by developmental issues and seizures in infants. Genetic mutations in the glial fibrillary acidic protein gene are now a key diagnostic marker.

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Area of Science:

  • Neuroscience
  • Genetics
  • Pediatric Neurology

Background:

  • Alexander disease is a rare, fatal central nervous system disorder.
  • It presents with varied symptoms across different age groups, from infancy to adulthood.
  • Characteristic neuropathological findings include Rosenthal fibers in brain tissue.

Purpose of the Study:

  • To summarize the clinical manifestations and diagnostic features of Alexander disease.
  • To highlight the role of genetic mutations in the diagnosis and understanding of the disease.
  • To provide an overview of Alexander disease across different age demographics.

Main Methods:

  • Review of clinical case presentations across infants, children, and adults.
  • Analysis of neuroimaging findings, particularly magnetic resonance imaging (MRI).

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  • Examination of neuropathological hallmarks, specifically Rosenthal fibers.
  • Genetic analysis to identify mutations in the glial fibrillary acidic protein (GFAP) gene.
  • Main Results:

    • Infantile and juvenile forms present with developmental delay, psychomotor retardation, seizures, and often megalencephaly.
    • Adult forms exhibit variable symptoms, sometimes mimicking multiple sclerosis, and may include palatal myoclonus.
    • Consistently identified are Rosenthal fibers in brain tissue across all age groups.
    • Heterozygous missense point mutations in the GFAP gene are found in nearly all cases, serving as a diagnostic tool.

    Conclusions:

    • Alexander disease is a genetically defined disorder linked to GFAP mutations.
    • The identification of GFAP mutations provides a significant diagnostic advancement.
    • Understanding the varied clinical presentations is crucial for accurate diagnosis and management.