Childhood ataxia with central nervous system hypomyelination (CACH) syndrome is an autosomal recessive transmitted leukodystrophy characterised by early childhood onset and acute deterioration following febrile illnesses or head trauma. We describe the case of a child with early onset of CACH syndrome. He presented with cerebellar ataxia beginning around two years of age with mild mental retardation. MRI showed diffuse white matter signal changes with thinning of the corpus callosum.
KayeE. Disorders primarily affecting white matter. In: SwaimannKAshwalS, eds. Pediatric Neurology Principles and Practice. 3rd Ed. Ch 55. St Louis: Mosby; 1999. p. 857.
2.
SchiffmannRMollerJRTrappBD. Childhood ataxia with diffuse central nervous system hypomyelination. Ann Neurol.1994; 35: 331–340.
3.
VermeulenGSeidlRMercimek-MahmutogluS. Fright is a provoking factor in vanishing white matter disease. Ann Neurol.2005; 57: 560–563.
4.
Van der KnaapMSLeegwaterPAKonstAA. Mutations in each of the five subunits of translation initiation factor eIF2B can cause leukoencephalopathy with vanishing white matter. Ann Neurol.2002; 51: 264–270.
5.
RichardsonJPMohammadSSPavittGD. Mutations causing childhood ataxia with central nervous system hypomyelination reduce eukaryotic initiation factor 2B complex formation and activity. Mol Cell Biol.2004; 24: 2352–2363.
6.
SchiffmannRBoespflug-TanguyO. An update on the leukodystrophies. Curr Opin Neurol.2001; 14: 789–794.
7.
Van der KnappMSBarthPGGabreelsFJ. A new leukoencephalopathy with vanishing white matter. Neurology.1997; 48: 845–855.
8.
Van der KnaapMSPronkJCScheperGC. Vanishing white matter disease. Lancet Neurol.2006; 5 (5): 413–423.
9.
WongKArmstrongRCGyureKA. Foamy cells with oligodendroglial phenotype in childhood ataxia with diffuse central system hypomyelination syndrome. Acta Neuropathol (Berl). 2000; 100: 635–646.
10.
FogliABoespflug-TanguyO. The large spectrum of eIF2B-related diseases. Biochem Soc Trans.2006; 34: 22–29.
11.
HorzinskiLGonthierCRodriguezD. Exon deletion in the non-catalytic domain of eIF2Bepsilon due to a splice site mutation leads to infantile forms of CACH/VWM with severe decrease of eIF2B GEF activity. Ann Hum Genet.2008; 72: 410–415.
12.
Van der KnappMSKamphorstWBarthPG. Phenotypic variation in leukoencephalopathy with vanishing white matter. Neurology.1998; 51: 540–547.