Reversible White Matter Lesions During Ketogenic Diet Therapy in Glucose Transporter 1 Deficiency Syndrome

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BackgroundGlucose transporter type 1 deficiency syndrome is caused by brain energy failure resulting from a disturbance in glucose transport. PatientsWe describe a 4-year-old boy with classical type glucose transporter type 1 deficiency syndrome with a heterozygous splice acceptor site mutation (c.517-2A>G) in the SLCA2A1 gene. ResultsWe initiated a ketogenic diet at 4 months of age. However, even though his condition was good during ketogenic diet therapy, multiple cerebral white matter and right cerebellum lesions appeared at 9 months of age. The lesions in the cerebral white matter subsequently disappeared, indicating that white matter lesions during diet therapy may be reversible and independent of the ketogenic diet. ConclusionsThis is the first report of reversible white matter lesions during ketogenic diet therapy in glucose transporter type 1 deficiency syndrome.