Vanishing white matter disease in French-Canadian patients from Quebec

Vanishing white matter disease is an autosomal recessive leukodystrophy caused by mutations in any of the five genes encoding the subunits of the eukaryotic translation initiation factor 2B. Most of the reported patients are of North American and European ancestry.

The objective of the study was to review the clinical, radiological, and molecular characteristics of vanishing white matter disease in a cohort of French-Canadian patients.

Between 2004 and March 2012, five French-Canadian (non-Cree) patients from Quebec were clinically and genetically diagnosed with vanishing white matter disease within three Montreal Neurogenetics and Leukodystrophy clinics. Their clinical presentation and evolution, demographic characteristics, genetic mutations, and imaging were reviewed and compared with what is known in the literature.

Sequencing of the exons and intronic boundaries of the EIF2B1-5 genes revealed a rare 260C>T (A87V) missense mutation in EIF2B3 in two homozygous patients and one compound heterozygous patient. This mutation was previously reported in only one patient in the literature. The carrier frequency is unknown. Also, three of five Quebec patients had an extremely rare vanishing white matter disease presentation of migraines with transient neurological abnormalities.

The 260C>T (A87V) mutation in exon 3 of the EIF2B3 gene is likely a founder mutation for vanishing white matter disease in Quebec. Transient hemiparesthesia and hemiparesis episodes accompanied by headaches as presenting abnormalities of vanishing white matter disease are usually rare but seemed to be more frequent among the French-Canadian Quebec patients. They seemed to be preceded by periods of stress.