Late Infantile Neuronal Ceroid Lipofuscinosis in a Filipino Child with Epilepsy and Progressive Neurodegeneration

Mary Anne D. Chiong1,2 and Benilda C. Sanchez-Gan2

1Institute of Human Genetics, National Institutes of Health,
University of the Philippines Manila
2Department of Pediatrics, College of Medicine and
Philippine General Hospital, University of the Philippines Manila

The neuronal ceroid lipofuscinoses correspond to a group of disorders characterized by neurodegeneration and intracellular buildup of auto-flourescent lipopigment (ceroid lipofuscin). They are classified by age of onset into infantile, late infantile, juvenile and adult forms. Among these, the late infantile type is caused by mutations in tripeptidyl peptidase 1 (TPP1) gene and is characterized by age of onset between 2-4 years, seizures, early progressive cognitive impairment and visual loss.

Our patient is a 4-year-old girl who presented at 2 years and 10 months old with seizures followed by ataxia, regression of skills and eventual visual decline. TPP1 enzyme activity was below normal for age. This report aims to increase the awareness of physicians on the cluster of symptoms characteristic of this disorder which will help facilitate early diagnosis and prompt institution of appropriate management.

Key Words: Late infantile neuronal ceroid lipofuscinosis, Neuronal ceroid lipofuscinosis type 2, Tripeptidyl peptidase 1