Inherited disorders of neurotransmitters in children and adults.
Inherited disorders of neurotransmitters are a group of neurometabolic syndromes attributable to a primary disturbance of neurotransmitter metabolism or transport. This is an enlarging group of recognized disorders requiring specialized diagnostic procedures for detection. This review considers clinical disorders of biopterin, catecholamines, serotonin, glycine, pyridoxine, and GABA metabolism. Newly described syndromes such as cerebral folate deficiency and pyridoxal-5-phosphate dependency are included. The disorders of the metabolic pathways of biopterin, catecholamines, and serotonin are linked due to their common synthetic components. Glycine encephalopathy represents an enlarging phenotype related to abnormalities of the glycine degradative cleavage system. Both pyridoxine and pyridoxal-5-phosphate dependency need to be considered in refractory neonatal seizures. The most common disorder of GABA metabolism is SSADH deficiency, which has a broad phenotype of mental retardation, epilepsy, ataxia, and hyporeflexia and which invokes the combined problems of elevated brain GABA and GHB.
Pearl
Phillip L
PL
Department of Neurology, Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC 22052, USA.
Capp
Philip K
PK
Novotny
Edward J
EJ
Gibson
K Michael
KM
D000328:Adult; D001708:Biopterins / Q000378:metabolism; D020739:Brain Diseases, Metabolic, Inborn / Q000235:genetics / Q000378:metabolism*; D002648:Child; D005494:Folic Acid Deficiency / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D018377:Neurotransmitter Agents / Q000378:metabolism*; D011732:Pyridoxal Phosphate / Q000378:metabolism; D011736:Pyridoxine / Q000378:metabolism; D013577:Syndrome
D018377:Neurotransmitter Agents; D001708:Biopterins; D011732:Pyridoxal Phosphate; D011736:Pyridoxine