An unusual case of late-infantile onset Krabbe disease with selective bilateral corticospinal tract involvement, peripheral demyelinating neuropathy, and mild phenotype

  • Francesco NicitaEmail author
  • Federica Graziola
  • Federico Vigevano
  • Enrico Bertini
  • Alessandro Capuano

A 17-year-old boy was evaluated for a history of mild delay in motor milestones by the 8 months of age and frequent falls from his first step by the age of 18 months. During the following of 13 years, the course has been stable and he never experienced motor or cognitive regression, seizures, or visual problems. Neurological examination showed no cognitive deficits, no difficulties with speech, and normal visual acuity and fields. Muscle hypotrophy of lower limbs was evident (Fig. 1a). He could stand and walk unsupported with mild stepping gait. Bright osteo-tendinous reflexes of the four limbs were present, without increased tone, Babinski sign, or clonus. No strength deficits were present, except for a mild weakness of bilateral extensor hallucis longus (MRC 4/5). Romberg and cerebellar tests, sensory, and vibration sense were normal. Nerve conduction studies revealed sensory-motor demyelinating neuropathy of the lower limbs. Motor-evoked potentials showed increased central...


Leukodystrophy Demyelinating GALC Krabbe disease Galactocerebrosidase Neuropathy 



The authors receive no funding sources for this study.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This case report study does not require ethical approval at our institution.

Informed consent

Written informed consent was obtained by patient's parents for performing genetic analysis according to the Declaration of Helsinki. Parents gave their written consent for publishing the picture of the patient.


  1. 1.
    Duffner PK, Barczykowski A, Kay DM, Jalal K, Yan L, Abdelhalim A, Gill S, Gill AL, Carter R (2012) Later onset phenotypes of Krabbe disease: results of the world-wide registry. Pediatr Neurol 46(5):298–306CrossRefGoogle Scholar
  2. 2.
    Abdelhalim AN, Alberico RA, Barczykowski AL, Duffner PK (2014) Patterns of magnetic resonance imaging abnormalities in symptomatic patients with Krabbe disease correspond to phenotype. Pediatr Neurol 50(2):127–134CrossRefGoogle Scholar
  3. 3.
    Yoshimura A, Kibe T, Irahara K, Sakai N, Yokochi K (2016) Predominant corticospinal tract involvement in a late infant with Krabbe disease. Jpn Clin Med 7:23–26CrossRefGoogle Scholar
  4. 4.
    Sehgal R, Sharma S, Sankhyan N, Kumar A, Gulati S (2011) Selective corticospinal tract involvement in late-onset Krabbe disease. Neurology 77(3):e20CrossRefGoogle Scholar
  5. 5.
    Kamate M, Hattiholi V (2011) Predominant corticospinal tract involvement in early-onset Krabbe disease. Pediatr Neurol 44:155–156CrossRefGoogle Scholar

Copyright information

© Belgian Neurological Society 2019

Authors and Affiliations

  1. 1.Unit of Neuromuscular and Neurodegenerative Diseases, Department of NeurosciencesBambino Gesù Research HospitalRomeItaly
  2. 2.Department of Neurosciences, Movement Disorders ClinicBambino Gesù Research HospitalRomeItaly
  3. 3.Unit of Neurology, Department of NeurosciencesBambino Gesù Research HospitalRomeItaly

Personalised recommendations