The Mole
GM2-Gangliosidosis
GM2-Gangliosidosis can be caused by a deficiency of hexosaminidase A (Tay-Sachs disease), or of hexosaminidases A and B (Sandhoff disease) or of GM2 activator protein (GM2 activator defect). Based on clinical features, the diseases cannot be distinguished. In the classic clinical picture, a pronounced sensitivity to noise is noticeable in the very first months of life. Loud noises such as closing doors or clapping hands lead to Moro-like motor manifestations. Already before the 6th month of life the motor development is limited. The diagnosis is often made because a cherry red spot is found during the ophthalmological examination. The infants are hypotonic, have poor head control. Verticalisation is delayed. A macrocephalus develops. At the beginning of the second year of life, the infants lose again their laboriously acquired abilities as well as vocalization and become blind. As a rule, the course is complicated by an epilepsy that is difficult to treat. Non-classical forms of the disease - described as juvenile or adult forms - are difficult to diagnose because the classic features are missing. The main findings in attenuated forms of epilepsy are motor developmental disorders and seizures with and without myoclonies in childhood, adolescence and young adulthood, a combination of early dementia, psychosis (often delusional), ataxia and distal paresis (motor neuron disease as in Friedreich's ataxia).
