Summary
Although they are classically viewed as paediatric diseases, it is now recognized that inborn errors of metabolism (IEMs) can present at any age from childhood to adulthood. IEMs can involve the peripheral nervous system, mostly as part of a more diffuse neurological or systemic clinical picture. However, in some cases, the neuropathy can be the unique initial sign. Here, based on our personal experience and on a comprehensive literature analysis, we review IEMs causing neuropathies in adults. Diseases were classified according to the predominant type of neuropathies into (1) acute neuropathies, (2) mononeuropathy multiplex, (3) chronic axonal polyneuropathies, (4) chronic demyelinating polyneuropathies, (5) small-fibre neuropathies, and (6) lower motor neuron disease.
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Baumgartner MR, Poll-The BT, Verhoeven NM, et al (1998a) Clinical approach to inherited peroxisomal disorders: a series of 27 patients. Ann Neurol 44: 720–730.
Baumgartner MR, Verhoeven NM, Jakobs C, et al (1998b) Defective peroxisome biogenesis with a neuromuscular disorder resembling Werdnig–Hoffmann disease. Neurology 51: 1427–1432.
Bodamer OA, Rosenblatt DS, Appel SH, Beaudet AL (2001) Adult-onset combined methylmalonic aciduria and homocystinuria (cblC). Neurology 56: 1113.
Bonne G, Benelli C, De Meirleir L, et al (1993) E1 pyruvate dehydrogenase deficiency in a child with motor neuropathy. Pediatr Res 33: 284–288.
Cafferty MS, Lovelace RE, Hays AP, Servidei S, Dimauro S, Rowland LP (1991) Polyglucosan body disease. Muscle Nerve 14: 102–107.
Chaudhry V, Moser HW, Cornblath DR (1996) Nerve conduction studies in adrenomyeloneuropathy. J Neurol Neurosurg Psychiatry 61: 181–185.
Crimlisk HL (1997) The little imitator—porphyria: a neuropsychiatric disorder. J Neurol Neurosurg Psychiatry 62: 319–328.
Debray FG, Lambert M, Vanasse M, et al (2006) Intermittent peripheral weakness as the presenting feature of pyruvate dehydrogenase deficiency. Eur J Pediatr 165: 462–466.
De Kooning TJ, Poll-The BT, Jaeken J (1999) Continuing education in neurometabolic disorders—serine deficiency disorders. Neuropediatrics 30: 1–4.
Donaghy M (1999) Classification and clinical features of motor neurone diseases and motor neuropathies in adults. J Neurol 246: 331–333.
England JD, Asbury AK (2004) Peripheral neuropathy. The Lancet 363: 2151–2161.
Ferdinandusse S, Denis S, Clayton PT, et al (2000) Mutations in the gene encoding peroxisomal alpha-methylacyl-CoA racemase cause adult-onset sensory motor neuropathy. Nat Genet 24: 188–191.
Fressinaud C, Vallat JM, Masson M, et al (1992) Adult-onset metachromatic leukodystrophy presenting as isolated peripheral neuropathy. Neurology 42: 1396–1398.
Henderson RD, MacMillan JC, Bradfield JM (2003) Adult onset Krabbe disease may mimic motor neurone disease. J Clin Neurosci 10: 638–639.
Ibdah JA, Tein I, Dionisi-Vici C, et al (1998) Mild trifunctional protein deficiency is associated with progressive neuropathy and myopathy and suggests a novel genotype–phenotype correlation. J Clin Invest 102: 1193–1199.
Jung KH, Ahn TB, Jeon BS (2005) Wilson disease with an initial manifestation of polyneuropathy. Arch Neurol 62: 1628–1631.
Kaufmann P, Pascual JM, Anziska Y, et al (2006) Nerve conduction abnormalities in patients with MELAS and the A3243G mutation. Arch Neurol 63: 746–748.
Kauppinen R (2005) Porphyrias. Lancet 365: 241–252.
King PH, Petersen NE, Rakhra R, Schreiber WE (2002) Porphyria presenting with bilateral radial motor neuropathy: evidence of a novel gene mutation. Neurology 58: 1118–1121.
Lacomis D, Roeske-Anderson L, Mathie L (2005) Neuropathy and Fabry’s disease. Muscle Nerve 31: 102–107.
Levade T, Graber D, Flurin V, et al (1994) Human beta-mannosidase deficiency associated with peripheral neuropathy. Ann Neurol 35: 116–119.
Levin KH (2004) Variants and mimics of Guillain Barre syndrome. Neurologist 10: 61–74.
Martinello F, Fardin P, Ottina M, et al (1998) Supplemental therapy in isolated vitamin E deficiency improves the peripheral neuropathy and prevents the progression of ataxia. J Neurol Sci 156: 177–179.
Milde P, Guccion JG, Kelly J, Locatelli E, Jones RV (2001) Adult polyglucosan body disease. Arch Pathol Lab Med 125: 519–522.
Miller RG, Davis CJ, Illingworth DR, Bradley W (1980) The neuropathy of abetalipoproteinemia. Neurology 30: 1286–1291.
Mitchell G, Larochelle J, Lambert M, et al (1990) Neurologic crises in hereditary tyrosinemia. N Engl J Med 322: 432–437.
Navon R, Khosravi R, Melki J, et al (1997) Juvenile-onset spinal muscular atrophy caused by compound heterozygosity for mutations in the HEXA gene. Ann Neurol 41: 631–638.
Needham M, Duley J, Hammond S, Herkes GK, Hirano M, Sue CM (2007) Mitochondrial disease mimicking Charcot-Marie Tooth disease. J Neurol Neurosurg Psychiatry 78: 99–100.
Oskoui M, Davidzon G, Pascual J, et al (2006) Clinical spectrum of mitochondrial DNA depletion due to mutations in the thymidine kinase 2 gene. Arch Neurol 63: 1122–1126.
Pasquier F, Lebert F, Petit H, Zittoun J, Marquet J (1994) Methylenetetrahydrofolate reductase deficiency revealed by a neuropathy in a psychotic adult. J Neurol Neurosurg Psychiatry 57: 765–766.
Peltola KE, Jaaskelainen S, Heinonen OJ, et al (2002) Peripheral nervous system in gyrate atrophy of the choroid and retina with hyperornithinemia. Neurology 59: 735–740.
Ramaekers VT, Brab M, Rau G, Heimann G (1993) Recovery from neurological deficits following biotin treatment in a biotinidase Km variant. Neuropediatrics 24: 98–102.
Schnorf H, Gitzelmann R, Bosshard NU, Spycher M, Waespe W (1995) Early and severe sensory loss in three adult siblings with hexosaminidase A and B deficiency (Sandhoff disease). J Neurol Neurosurg Psychiatry 59: 520–523.
Sedel F, Lyon-Caen O, Saudubray JM (2007). Inborn errors of metabolism in adult neurology—a clinical approach focused on treatable diseases. Nat Clin Pract Neurol 3: 279–290.
Sinha S, Mahadevan A, Lokesh L (2004) Tangier disease—a diagnostic challenge in countries endemic for leprosy. J Neurol Neurosurg Psychiatry 75: 301–304.
Spiekerkoetter U, Bennett MJ, Ben-Zeev B, Strauss AW, Tein I (2004) Peripheral neuropathy, episodic myoglobinuria, and respiratory failure in deficiency of the mitochondrial trifunctional protein. Muscle Nerve 29: 66–72.
Stibler H, Blennow G, Kristiansson B, Lindehammer H, Hagberg B (1994) Carbohydrate-deficient glycoprotein syndrome: clinical expression in adults with a new metabolic disease. J Neurol Neurosurg Psychiatry 57: 552–556.
Van Goethem G, Martin JJ, Dermaut B, et al (2003) Recessive POLG mutations presenting with sensory and ataxic neuropathy in compound heterozygote patients with progressive external ophthalmoplegia. Neuromuscul Disord 13: 133–142.
Verrips A, van Engelen BG, ter Laak H, et al (2000) Cerebrotendinous xanthomatosis. Controversies about nerve and muscle: observations in ten patients. Neuromuscul Disord 10: 407–414.
Wanders RJ (2004) Peroxisomes, lipid metabolism, and peroxisomal disorders. Mol Genet Metab 83: 16–27.
Wasserstein MP, Aron A, Brodie SE, Simonaro C, Desnick RJ, McGovern MM (2006) Acid sphingomyelinase deficiency: prevalence and characterization of an intermediate phenotype of Niemann–Pick disease. J Pediatr 149: 554–559.
Wevers RA, Hansen SI, van Hellenberg Hubar JL, Holm J, Hoier-Madsen M, Jongen PJ (1994) Folate deficiency in cerebrospinal fluid associated with a defect in folate binding protein in the central nervous system. J Neurol Neurosurg Psychiatry 57: 223–226.
Wills AJ, Manning NJ, Reilly MM (2001) Refsum’s disease. QJM 94: 403–406.
Züchner S, Vance JM (2006) Mechanisms of disease: a molecular genetic update on hereditary axonal neuropathies. Nat Clin Pract Neurol 2: 45–53.
Zuchner S, Sperfeld AD, Senderek J, et al (2003) A novel nonsense mutation in the ABC1 gene causes a severe syringomyelia-like phenotype of Tangier disease. Brain 126: 920–927.
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Communicating editor: Michael Gibson
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Sedel, F., Barnerias, C., Dubourg, O. et al. Peripheral neuropathy and inborn errors of metabolism in adults. J Inherit Metab Dis 30, 642–653 (2007). https://doi.org/10.1007/s10545-007-0684-x
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DOI: https://doi.org/10.1007/s10545-007-0684-x