Leigh syndrome
Leigh's disease is a rare inherited
neurometabolic disorder that affects the central nervous system. This
progressive disorder begins in infants between the ages of three months and two
years. Rarely, it occurs in teenagers and adults. Leigh's disease can
be caused by mutations in mitochondrial DNA or by deficiencies of an enzyme
called pyruvate dehydrogenase. Symptoms of Leigh's disease usually progress
rapidly. The earliest signs may be poor sucking ability,and the loss of head
control and motor skills.These symptoms may be accompanied by loss of appetite,
vomiting, irritability, continuous crying, and seizures. As the disorder
progresses, symptoms may also include generalized weakness, lack of muscle
tone, and episodes of lactic acidosis, which can lead to impairment of
respiratory and kidney function.
In Leigh’s disease, genetic mutations in mitochondrial DNA
interfere with the energy sources that run cells in an area of the brain that
plays a role in motor movements. The primary function of mitochondria is
to convert the energy in glucose and fatty acids into a substance called
adenosine triphosphate (ATP). The energy in ATP drives virtually all of a
cell's metabolic functions. Genetic mutations in mitochondrial DNA, therefore,
result in a chronic lack of energy in these cells, which in turn affects the
central nervous system and causes progressive degeneration of motor functions.
There is also a form of Leigh’s disease (called X-linked Leigh's
disease) which is the result of mutations in a gene that produces another group
of substances that are important for cell metabolism. This gene is only found
on the X chromosome.
The most common treatment for Leigh's disease is thiamine or
Vitamin B1. Oral sodium bicarbonate or sodium citrate may also be prescribed to
manage lactic acidosis. Researchers are currently testing dichloroacetate to
establish its effectiveness in treating lactic acidosis. In individuals who
have the X-linked form of Leigh’s disease, a high-fat, low-carbohydrate diet
may be recommended.
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