A rare neurodegenerative condition of infancy or childhood characterized by white matter vacuolization and demeylination that gives rise to a spongy appearance. Aspartoacylase deficiency leads to an accumulation of N-acetylaspartate in
astrocytes. Inheritance may be autosomal recessive or the illness may occur sporadically. This illness occurs more frequently in individuals of Ashkenazic Jewish descent. The neonatal form features the onset of hypotonia and
lethargy at birth, rapidly progressing to
coma and
death. The infantile form features developmental delay,
dyskinesias, hypotonia, spasticity,
blindness, and megalencephaly. The juvenile form is characterized by
ataxia;
optic atrophy; and
dementia. (From Adams et al., Principles of
neurology, 6th ed, p944; Am J Med Genet 1988 Feb;29(2):463-71)