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Defects of pyruvate metabolism and the Krebs cycle.
[pyruvate dehydrogenase deficiency]
Seizures
and
metabolic
disease
are
frequently
associated
,
either
indirectly
as
a
consequence
of
the
metabolically
caused
brain
dysgenesis
or
directly
by
the
metabolic
derangement
.
This
article
describes
defects
in
pyruvate
metabolism
(
pyruvate
carboxylase
deficiency
,
pyruvate
dehydrogenase
deficiency
)
and
Krebs
cycle
defects
such
as
fumarase
deficiency
.
Clinical
characterizations
and
diagnostic
strategies
have
been
developed
for
each
of
these
diseases
.
In
contrast
,
very
little
is
known
about
the
specific
epileptic
features
in
these
disorders
.
In
females
with
a
pyruvate
dehydrogenase
deficiency
E
1
alpha
owing
to
the
mutation
in
the
subunit
E
1
alpha
of
the
pyruvate
dehydrogenase
complex
West
's
syndrome
associated
with
large
ventricles
and
corpus
callosum
agenesis
on
magnetic
resonance
imaging
can
be
the
main
feature
of
the
disease
.
In
fumarase
deficiency
,
prenatal
brain
dysgenesis
is
the
most
prominent
feature
of
the
disease
.
Diagnosis
of
these
disorders
requires
measurements
of
lactate
and
pyruvate
in
plasma
and
cerebrospinal
fluid
,
analysis
of
amino
acids
in
plasma
and
organic
acids
in
urine
,
and
neuroradiologic
investigations
.
Further
biochemical
and
molecular
analysis
leads
to
a
definitive
diagnosis
and
opens
the
way
to
adequate
treatment
,
genetic
counseling
,
and
prenatal
diagnosis
.
Diseases
Validation
Diseases presenting
"corpus callosum agenesis on magnetic resonance imaging can be the main feature of the disease"
symptom
pyruvate dehydrogenase deficiency
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