The clinical, neurophysiological and pathological features of a patien
t who presented with the clinical features of juvenile Batten disease,
yet who had storage of granular osmiophilic deposits (GROD) on ultras
tructural examination of biopsy and postmortem tissues is described. T
he ultrastructural features are those usually found in the infantile f
orm of Batten disease. The postmortem study showed marked neuronal sto
rage of a lipofuscin-like material in an atrophic brain without loss o
f myelin. The cerebellum showed almost complete loss of Purkinje cells
and loss of the granule cells. No accumulation of subunit c of mitoch
ondrial ATP synthase was found. The clinical and neurophysiological fi
ndings are compared with those of the classical juvenile form and with
those of the few reported cases of juvenile Batten disease with GROD.
The importance of correct classification of patients with Batten dise
ase and its impact on the molecular genetic studies is emphasised. The
pathogenesis of this form of the disease is considered to be similar
to that for infantile Batten disease.