L-2 hydroxyglutaric aciduria presenting with status epilepticus

BMJ Case Rep. 2013 Jun 7:2013:bcr2013010164. doi: 10.1136/bcr-2013-010164.

Abstract

L-2 Hydroxyglutaric aciduria is a rare, progressive, autosomal recessively inherited metabolic disorder of organic acid metabolism. It is characterised by macrocephaly, progressive neurological syndrome with cerebellar features, mental deterioration, typical brain MRI findings and the presence of L-2 hydroxyglutaric acid in urine samples. We report on an 11-year-old patient who presented to the emergency department with a generalised status epilepticus, which was subsequently diagnosed as L-2 hydroxyglutaric aciduria owing to rare and different clinical presentation. Brain MRI showed peripheral white matter abnormalities in cerebral hemispheres, basal ganglia and dentate nuclei, In conclusion, L-2 hydroxyglutaric aciduria should be considered in cases of epileptic seizures such as status epilepticus, cerebellar signs and progressive neurological course.

Publication types

  • Case Reports

MeSH terms

  • Brain Diseases, Metabolic, Inborn / complications
  • Brain Diseases, Metabolic, Inborn / diagnosis*
  • Brain Diseases, Metabolic, Inborn / diet therapy
  • Brain Diseases, Metabolic, Inborn / drug therapy
  • Carnitine / therapeutic use
  • Child
  • Diagnosis, Differential
  • Dietary Proteins / administration & dosage
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Riboflavin / therapeutic use
  • Status Epilepticus / complications
  • Status Epilepticus / diagnosis*
  • Treatment Outcome

Substances

  • Dietary Proteins
  • Carnitine
  • Riboflavin

Supplementary concepts

  • 2-Hydroxyglutaricaciduria