An 11-year-old girl died of a neuronal storage disorder that clinicall
y was characterized by failure to thrive and muscular hypotonia from b
irth, with the subsequent evolution of motor neuron disease, epilepsy,
and dementia. A wide range of metabolic disorders, including all form
s of GM2 gangliosidosis, could be excluded. Electron microscopy demons
trated neuronal zebra body inclusions, and immunohistochemistry demons
trated that GM2 ganglioside was a major constituent of the storage mat
erial. We suggest that the patient died of a lysosomal storage disease
that is clinically and biochemically different from Tay-Sachs disease
, Sandhoff disease, and other GM2 gangliosidoses described previously.
This case also further demonstrates that significant accumulation of
GM2 ganglioside, which is crucial for dendritic formation, may occur i
n neuronal storage diseases lacking known defects in ganglioside catab
olism. (C) 1997 by Elsevier Science Inc.