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Megalencephalic leukoencephalopathy with subcortical cysts

Reviewed November 2008

What is megalencephalic leukoencephalopathy with subcortical cysts?

Megalencephalic leukoencephalopathy with subcortical cysts is a progressive condition that affects brain development and function. Individuals with this condition typically have an enlarged brain (megalencephaly) that is evident at birth or within the first year of life. Megalencephaly progressively increases the size of the head. Affected people also have leukoencephalopathy, an abnormality of the brain's white matter. White matter consists of nerve fibers covered by a fatty substance called myelin. Myelin insulates nerve fibers and promotes the rapid transmission of nerve impulses. In megalencephalic leukoencephalopathy with subcortical cysts, the myelin is swollen and stippled with fluid-filled pockets (vacuoles). Over time, the swelling decreases and the myelin begins to waste away (atrophy). Individuals affected with this condition may develop subcortical cysts below an area of the brain called the cerebral cortex. These cysts can grow in size and number.

People with megalencephalic leukoencephalopathy with subcortical cysts typically experience abnormal tensing of the muscles (spasticity) and difficulty coordinating movements (ataxia). Walking ability varies greatly among those affected. Some people lose the ability to walk early in life and need wheelchair assistance, while others are able to walk unassisted well into adulthood. Affected individuals may also develop abnormal muscle tone (dystonia), involuntary writhing movements of the limbs (athetosis), difficulty swallowing (dysphagia), and impaired speech (dysarthria). Despite the widespread brain abnormalities, people with this condition typically have only mild to moderate intellectual impairment. More than half of all people with this condition have recurrent seizures (epilepsy). Seizures can occur without warning or may follow minor head trauma. Additionally, minor head trauma can further impair movements and may lead to coma.

How common is megalencephalic leukoencephalopathy with subcortical cysts?

Megalencephalic leukoencephalopathy with subcortical cysts is a rare condition; at least 150 cases have been reported.

What genes are related to megalencephalic leukoencephalopathy with subcortical cysts?

Mutations in the MLC1 gene cause most cases of megalencephalic leukoencephalopathy with subcortical cysts. The MLC1 gene provides instructions for producing a protein that is found in the brain, spleen, and white blood cells (leukocytes). Within the brain, the MLC1 protein is found in specialized cells called astroglial cells, which support and nourish other cells. Research suggests that astroglial cells play an important role in the long-term maintenance of myelin. The precise function of the MLC1 protein in astroglial cells, the spleen, and leukocytes is unknown.

MLC1 gene mutations inhibit the production of functional MLC1 protein. Most mutations probably alter the structure of the MLC1 protein or prevent the cell from producing any of this protein. It is unknown how a lack of functional MLC1 protein impairs brain development and function, causing the signs and symptoms of megalencephalic leukoencephalopathy with subcortical cysts.

Approximately 25 percent of people with megalencephalic leukoencephalopathy with subcortical cysts do not have identified mutations in the MLC1 gene. In these individuals, the cause of the disorder is unknown. Mutations in one or more as-yet unidentified genes may be responsible for the disorder in these cases.

Related Gene(s)

Changes in this gene are associated with megalencephalic leukoencephalopathy with subcortical cysts.

  • MLC1

How do people inherit megalencephalic leukoencephalopathy with subcortical cysts?

This condition is inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.

Where can I find information about diagnosis or management of megalencephalic leukoencephalopathy with subcortical cysts?

These resources address the diagnosis or management of megalencephalic leukoencephalopathy with subcortical cysts and may include treatment providers.

  • Gene Review: Megalencephalic Leukoencephalopathy with Subcortical Cysts (http://www.ncbi.nlm.nih.gov/books/NBK1535)
  • Genetic Testing Registry: Megalencephalic leukoencephalopathy with subcortical cysts 1 (http://www.ncbi.nlm.nih.gov/gtr/conditions/C1858854)
  • MedlinePlus Encyclopedia: Myelin (http://www.nlm.nih.gov/medlineplus/ency/article/002261.htm)

You might also find information on the diagnosis or management of megalencephalic leukoencephalopathy with subcortical cysts in Educational resources (http://www.ghr.nlm.nih.gov/condition/megalencephalic-leukoencephalopathy-with-subcortical-cysts/show/Educational+resources) and Patient support (http://www.ghr.nlm.nih.gov/condition/megalencephalic-leukoencephalopathy-with-subcortical-cysts/show/Patient+support).

General information about the diagnosis (http://ghr.nlm.nih.gov/handbook/consult/diagnosis) and management (http://ghr.nlm.nih.gov/handbook/consult/treatment) of genetic conditions is available in the Handbook. Read more about genetic testing (http://ghr.nlm.nih.gov/handbook/testing), particularly the difference between clinical tests and research tests (http://ghr.nlm.nih.gov/handbook/testing/researchtesting).

To locate a healthcare provider, see How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

Where can I find additional information about megalencephalic leukoencephalopathy with subcortical cysts?

You may find the following resources about megalencephalic leukoencephalopathy with subcortical cysts helpful. These materials are written for the general public.

You may also be interested in these resources, which are designed for healthcare professionals and researchers.

What other names do people use for megalencephalic leukoencephalopathy with subcortical cysts?

  • infantile leukoencephalopathy and megalencephaly
  • leukoencephalopathy with swelling and a discrepantly mild course
  • leukoencephalopathy with swelling and cysts
  • LVM
  • MLC
  • vacuolating leukoencephalopathy
  • vacuolating megalencephalic leukoencephalopathy with subcortical cysts
  • Van der Knapp disease
  • VL

For more information about naming genetic conditions, see the Genetics Home Reference Condition Naming Guidelines (http://ghr.nlm.nih.gov/ConditionNameGuide) and How are genetic conditions and genes named? (http://ghr.nlm.nih.gov/handbook/mutationsanddisorders/naming) in the Handbook.

What if I still have specific questions about megalencephalic leukoencephalopathy with subcortical cysts?

Ask the Genetic and Rare Diseases Information Center (http://rarediseases.info.nih.gov/GARD/).

What glossary definitions help with understanding megalencephalic leukoencephalopathy with subcortical cysts?

ataxia ; atrophy ; autosomal ; autosomal recessive ; cell ; cerebral cortex ; coma ; cysts ; difficulty swallowing ; dysarthria ; dysphagia ; dystonia ; epilepsy ; gene ; inherited ; involuntary ; leukodystrophy ; leukoencephalopathy ; macrocephaly ; megalencephaly ; muscle tone ; protein ; recessive ; spasticity ; subcortical ; trauma ; white blood cells ; white matter

You may find definitions for these and many other terms in the Genetics Home Reference Glossary (http://www.ghr.nlm.nih.gov/glossary).

References

  • Gorospe JR, Maletkovic J. Alexander disease and megalencephalic leukoencephalopathy with subcortical cysts: leukodystrophies arising from astrocyte dysfunction. Ment Retard Dev Disabil Res Rev. 2006;12(2):113-22. Review. (http://www.ncbi.nlm.nih.gov/pubmed/16807904?dopt=Abstract)
  • Ilja Boor PK, de Groot K, Mejaski-Bosnjak V, Brenner C, van der Knaap MS, Scheper GC, Pronk JC. Megalencephalic leukoencephalopathy with subcortical cysts: an update and extended mutation analysis of MLC1. Hum Mutat. 2006 Jun;27(6):505-12. (http://www.ncbi.nlm.nih.gov/pubmed/16652334?dopt=Abstract)
  • Montagna G, Teijido O, Eymard-Pierre E, Muraki K, Cohen B, Loizzo A, Grosso P, Tedeschi G, Palacín M, Boespflug-Tanguy O, Bertini E, Santorelli FM, Estévez R. Vacuolating megalencephalic leukoencephalopathy with subcortical cysts: functional studies of novel variants in MLC1. Hum Mutat. 2006 Mar;27(3):292. (http://www.ncbi.nlm.nih.gov/pubmed/16470554?dopt=Abstract)
  • Pascual-Castroviejo I, van der Knaap MS, Pronk JC, García-Segura JM, Gutiérrez-Molina M, Pascual-Pascual SI. Vacuolating megalencephalic leukoencephalopathy: 24 year follow-up of two siblings. Neurologia. 2005 Jan-Feb;20(1):33-40. (http://www.ncbi.nlm.nih.gov/pubmed/15704020?dopt=Abstract)
  • Singhal BS, Gorospe JR, Naidu S. Megalencephalic leukoencephalopathy with subcortical cysts. J Child Neurol. 2003 Sep;18(9):646-52. Review. (http://www.ncbi.nlm.nih.gov/pubmed/14572144?dopt=Abstract)
  • Yalçinkaya C, Yüksel A, Comu S, Kiliç G, Cokar O, Dervent A. Epilepsy in vacuolating megalencephalic leukoencephalopathy with subcortical cysts. Seizure. 2003 Sep;12(6):388-96. (http://www.ncbi.nlm.nih.gov/pubmed/12915085?dopt=Abstract)

 

The resources on this site should not be used as a substitute for professional medical care or advice. Users seeking information about a personal genetic disease, syndrome, or condition should consult with a qualified healthcare professional. See How can I find a genetics professional in my area? (http://ghr.nlm.nih.gov/handbook/consult/findingprofessional) in the Handbook.

 
Reviewed: November 2008
Published: December 16, 2014